Collection Specialist/Payment Poster

In this position, you will be responsible for medical billing support, for both inpatient and outpatient claims, and providing claims follow up for any and all payers. You will need to be able to multitask and prioritize responsibilities. This position is an essential supporter of the mission, vision and values of the organization and maintains the highest degree of confidentiality in patient and staff, fiscal and organizational matters, and has a detailed comprehension and diligent adherence to all HIPAA regulations and requirements. This position is also responsible for posting payments which are auto-posted in our billing software and reconciling the accuracy of those payments to individual patient accounts.

jOB KNOWLEDGE AND REQUIREMENTS:

• Detailed knowledge in preparing and submitting clean claims to various insurance companies and payers, either electronically or on paper
• Knowledge and understanding of identifying and resolving insurance and patient billing matters
• Corrects coding and/or data entry errors and resubmits claims to payers, whenever necessary
• Follow up on unpaid claims within the standardized billing cycle timeframe
• Researches payment denials and re-submit for payment, whenever necessary
• Ability to gather and submit all appeals and required support documentation in order to facilitate prompt payments, paying close attention to timely filing requirements
• Ability to speak to a multitude of payer types to determine expedient resolutions to claims denials
• Performing health plan and payer patient eligibility checks to ensure appropriate financial responsibilities are identified in order to achieve “clean claim” submissions, and reduce denials or delays in reimbursements
• Ability to accurately post auto-post payments to patient accounts ensuring that payments are in-balance and reconcile with payer details
• Identifying incorrect payments and processing appropriate correspondence to correct errors
• Provide exceptional patient relations and ability to answer all patient or insurance company inquiries pertaining to any account
• Outstanding time management, organizational and problem solving skills
• Must be well organized, detail-oriented and possess the ability to perform effectively in a team environment
• Provides courteous, timely and professional assistance to internal and external customers in a consistently business-like and polite manner
• Any additional tasks, as assigned by management

Education, Knowledge and Experience:

• High School Diploma or GED required. AA degree in business or any healthcare discipline, a plus.
• Minimum Five (5) years’ experience as a Biller or Collector, Payment Poster-(Inpatient billing and Specialty billing, a plus. Well-rounded knowledge of medical terminology, billing procedures as well as CPT and ICD-10 coding
• Extensive experience and knowledge in Medicare, California State Medi-Cal, Work Comp, Managed Care and other medical/health insurances reimbursement principals
• Proficient in written and spoken English
• Bilingual in Spanish, a plus
• Data entry skills should be exceptional; skills in self-proofing essential
• Ability to use critical thinking skills to interpret information furnished in written and oral form
• Sound decision making ability to prioritize tasks based on available information
• Evaluates situations and requirements in order to plan and adjust work accordingly
• Above average math skills to add, subtract, multiply and divide.

Software and Equipment:

• Uses Microsoft Word, Excel, Outlook, Email and Internet, proficiently
• Experience working with an EMR and billing software, (Office Ally Practice Mate experience is a plus)
• Uses dedicated software to perform billing tasks.
• Ability to learn new programs quickly
• Ability to use standard office equipment

Environmental/Working Conditions:

• Customary medical business office environment.

Physical Demands:

• Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a computer keyboard and other standard office equipment.
• This job description is intended to provide basic guidelines for meeting job requirements.
• Responsibilities, skills and working conditions may change as needs evolve.
• Salary commensurate with experience
• Other responsibilities as assigned by supervisor