REMOTE- Billing Collections Job at Cypress Healthcare Partners
POSITION/JOB SUMMARY:
Responsible for billing, payment posting and collection of physician services. Under the limited supervision of the Billing & Collection Manager or Team Leader, responsible for the “back office” functions of billing/payment and posting/collections, using Company’s physician billing and collection system. Duties include typing, filing, computer input and telephone communications with patients and insurance companies.
SUPERVISORY RESPONSIBILITIES:
None
KEY RESPONSIBILITIES & DUTIES:
- Using the Company’s Practice Management system, responsible for filing medical claims and statements for all third-party payers, including insurance companies, PPOs, HMOs, Medicare, CCAH, Medi-Cal, Tricare, workers’ compensation carriers, and other payers
- Ensures that goals and objectives established in conjunction with senior management and Billing and Collection Improvement Team are attained.
- Learns and becomes an advanced user of Practice Management billing system.
- Transmits appropriate forms to payers and/or patients.
- Inputs computer information for electronic processing and edit of eligible claims. Processes electronic billing and claims submission.
- Analyzes edit reports; identifies and rectifies problems to ensure timely and accurate reimbursement.
- Reviews insurance return mail and determines reasons for return.
- Accurately posts payments from EOBs. Ensures payments correctly reflect billed charges and appropriate reimbursement. Reconciles payment-posting batches with deposits on a daily basis. Accuracy is critical. Consults with Company’s Certified Professional Coders on issues of denials, downcodes and improper reimbursement. Uses proper “denial codes” and other notes/comments when posting payment into the Practice Management system.
- Stays informed of changes in billing procedures that impact process and/or reimbursement effectiveness.
- Answers and researches phone and mail billing inquiries from patients and insurance companies, promptly, courteously and accurately.
- Posts refund requests and disputes in account and disburses paper work to the appropriate staff.
- Processes correspondence and requests from payers. Does not become delinquent in this important task; requests assistance via e-mail or memo from the B&C Manager if behind or backlogged.
- Post all necessary notations on accounts.
- Verify duplicate payments and post or refund per policy.
- All billing and payment posting should be kept current
- Collect accounts for assigned providers and groups and keep accounts receivable aging within specified ranges, including telephonic and written communications to delinquent accounts (e.g., collection letters). You may be directed to work collections for a specific payor category (e.g., Medicare, workers’ compensation, client occupational health services, insurances, self-pay, etc.)
- Review delinquent account records to determine which patients must be contacted for collection of overdue accounts, using the Practice Management collection module and other tools provided by senior management. You will likely be given a minimum quota for production through the collection module, and failure to meet or exceed quota will be grounds for counseling or dismissal. Employees are expected to improve in their productivity as they gain experience in position and with the Practice Management system.
- Provide input on appropriate A/R and collections goals and meets A/R and collection goals and objectives set by Team Leader and Senior Management.
- Verify accuracy of accounts. If an error in an account is detected during the collection process, the employee shall fix the error or report it to the appropriate person (e.g Team Leader or Billing & Collection Department Manager) and document it in the account.
- Develop and follow procedures to minimize write-offs.
- Adjust errors and deal with patient and payer complaints. Quality and patient satisfaction are the principal missions of the Company.
- Coordinate with payment posters to ensure proper payment posting. Confirm and test that appropriate contractual write-offs are posted at time of payment posting and that no unnecessary or incorrect contractual write-offs and adjustments are being taken.
KNOWLEDGE, SKILLS, AND ABILITIES:
- Must be able to communicate effectively in English, verbally and written.
- Must be able to write reports, business correspondence, and procedure manuals using good, proper grammar.
- Able to effectively present information and respond to questions from groups of managers, clients, customers, and the public.
- Excellent customer service and phone etiquette skills.
- Must be able to maintain a high degree of confidentiality and work well under productivity standards.
- Able to prioritize and balance workload on short and long-term company needs.
- Must be able to work independently and be able to solve problems efficiently and accurately.
- Able to create channels of communication to obtain information necessary to perform job tasks.
- Strong organizational skills with the ability to prioritize a high-volume workload.
- Helpful attitude, positive teamwork spirit with a willingness to help.
CREDENTIALS / EDUCATION / EXPERIENCE:
- GED recommended; or one to two years related experience and/or training, or equivalent combination of education and experience.
- Must have current California RN or LVN license or Medical Assistant certificate
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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job:
- The employee is required to use repetitive hand motions to handle various help desk requests.
- The employee frequently is required to stand, sit, and reach with hands and arms.
- The employee is occasionally required to walk; climb or balance; and stoop, kneel, crouch, or crawl.
- The employee must occasionally lift and/or move up to 20 pounds. For example, the employee is required to unpack, move, lift and install PCs, monitors, and printers in various locations at the Company’s clinics and offices.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, and ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duty of this job, the employee is occasionally exposed to moving mechanical parts (medical and office equipment), risk of working with blood borne pathogens, and risk of radiation (from office equipment such as computer monitors).
- The noise level in the work environment is usually moderate.
- This environment can be stressful and high pressure.
- Individuals must enjoy working in such environments and be willing to adapt the pace of their work and output to the patient volumes and tasks of the office.
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