Campus Pride Jobs

[Summary[: [The Medical Billing and Collections Specialist is a key team member responsible for advanced computerized billing and electronic claim submission functions, with a specific focus on collections. This role involves handling difficult, demanding, and complex tasks, requiring specialized knowledge to modify existing methods, solve problems, and complete tasks, especially in the context of collections. Work is typically performed under general direction.

[Essential Duties and Responsibilities[:]{verdana",sans-serif"=""}]{verdana",sans-serif"=""}]{verdana",sans-serif"=""}]{verdana",sans-serif"=""}]{verdana",sans-serif"=""}

• Primary Biller responsible for all electronic billing to insurance carriers as required by contract or industry standards.
• Inform members of other departments about discrepancies in patient accounts, data entry errors, accounts receivable issues, inventory issues, and follow-up issues. Resolve issues in a timely manner to facilitate billing completion.
• Follow the order through to completion by validating the receipt of appropriate paperwork, including prescriptions, delivery tickets, orientation checklists, and chart establishment.
• Appropriately bill for the products/services received by the patient per Company policy and procedure.
• Re-bill or bill for purchased products/services re-rented by the patient, consistent with Company policy and procedure.
• Routinely review billing status reports to maintain current billing and identify discrepancies/omissions.

[Collections:]{verdana",sans-serif"=""}

• Proactively pursue and resolve denied, non-payment or short-paid claims.
• Conduct intensive research to resolve denied or short-paid claims and manage outstanding accounts.
• Develop proactive problem-solving methods related to departmental processes, Company processes, and/or database software.
• Provide or recommend solutions to a variety of problems.
• Provide general guidance and training to other non-exempt staff and team members.
• Act as a liaison between departmental management and subordinate non-exempt team members on issues regarding departmental procedures, concerns, or recommendations for improvement.
• Maintain advanced knowledge of paper and computer systems related to departmental systems and hardware/software utilization.
• Maintain general knowledge of VQ OrthoCare product line.
• Maintain specialized knowledge of billing and electronic submission practices, procedures, and policies.
• Maintain specialized knowledge of Medicare and familiarity with group insurance and workers compensations practices.
• Maintain familiarity with HIPAA regulations related to maintaining confidentiality of patient information.
• Apply basic billing concepts to business actions and reporting.

[Qualifications[: [To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions. ]{verdana",sans-serif"=""}]{verdana",sans-serif"=""}]{verdana",sans-serif"=""}