Job Description
Specialty Billing is responsible for verifying all benefits as they pertain to specialty drug injections and all the co-pay assistance funds as well as follow up with accounts receivable for any necessary payer.
Essential Functions
- The primary function is to verify all benefits for scheduled injection appointments.
- Evaluates all benefits for patient responsibility and notates accurate collection amounts.
- Obtain all necessary pre-authorization or pre-determination for each patient to have treatment with a specialty drug.
- Monitor all assigned schedules for add-ons and changes.
- Assist in general billing AR when needed including but not limited to claims follow up, calls to insurance and anything necessary to obtain payment for all specialty drugs.
- Recognizes, interprets and evaluates inconsistencies, discrepancies and inaccuracies in accounts along with system files, and initiates appropriate corrective methods.
- Act as customer service representative in person or by telephone for any patient's questions about his/her account.
- Maintain up to date billing knowledge of insurance carriers and their clinical policies.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Competencies
- Problem Solving / Analysis - Creative problem solving within defined acceptable parameters. Identifies and resolves problems in a timely fashion.
- Customer Service- superior listening skills, professional demeanor and appropriate firmness.
- Conflict Resolution- responds promptly to customer needs. Ability to handle difficult patient interactions relative to sensitive billing issues.
- Detail Oriented - ensure proper procedures, protocol and processes are complied with consistently.
- Strong Interpersonal Skills- Works effectively with patients, employees and physicians.
- Creative problem solving within defined acceptable parameters.
- Time Management- maintains high volume productivity level for essential functions.
- Ethical Conduct - Maintains confidentiality.
This position has no direct supervisory responsibilities.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk, communicate verbally in front of groups, 1:1 and over the telephone and in email. The employee will also be required to engage in interactive communication with employees, typically hearing and reading / responding to their emails.
This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, bend and reach open filing cabinets and bend or stand on a stool as necessary. This job requires the ability to sit upright at a desk using a keyboard, computer, mouse and telephone.
Position Type/Expected Hours of Work
This is a full-time position. Occasional over time may be required with little or no advance notice.
Travel
Travel is estimated to be 10% with advance notice for this position.
Required Education And Experience
- Minimum of three years experience in medical billing.
- Knowledge of benefit investigation including obtaining eligibility information, authorizations and referrals.
- Experience with CPT, ICD9 and ICD10, Microsoft Office Suite required.
MAR is a proud Equal Opportunity Employer.
Job Posted by ApplicantPro
