Medical Billing Specialist at Southern Colorado Retina MSO, LLC in Colorado Springs, Colorado

Job Description:

Reports to: Billing Supervisor Department: Front Office
Job Type: Full-Time FLSA Status: Non-Exempt
Location: Colorado Springs Revised: December 30, 2022
General Purpose
The Medical Billing Specialist position supports the Billing supervisor in various administrative and billing related tasks.
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 individuals with disabilities to perform the essential functions.
Essential Duties/Responsibilities

Scrub medical claims to check for bundled codes, proper modifier placement, correct number of units for CPT codes, as well as ensuring correct line charge total.
Maintain insurance address database with Nextech.
Works with insurance companies to assist with chart reviews.
Merge patient charts.
Respond to insurance requests for medical records.
Perform basic customer service for routine patients or other inquiries.
Interprets eligibility responses from insurance companies.
Work claims rejections/denials.
Post patient and insurance payments.
Review/work insurance requests for recoupments.
Review insurance payments to ensure payments are correct.
Receive and interpret insurance benefit investigations from drug manufacturing companies.
Sign patients up for copay assistance.
Order/maintain injectable drug inventory.
Follow proper medical and insurance claims processes.
Review and verify medical bills and invoices with accounts receivable ledger and patients.
Maintain and update various billing spreadsheets utilized for information and/or tracking.

Other Duties/Responsibilities

Other accounting duties as needed.
Attends team and staff meetings.
Performs other duties as assigned.

Supervisory Duties (if any)

None

Job Qualifications
Knowledge, Skills, and Ability:

Knowledge of general ledger accounting principles.
General knowledge of insurance companies and agreements with health providers.
Ability to use accounting software.
Ability to pay attention to detail.
Ability to use internet, email, MS Office and other job-related software products.
Ability to communicate effectively in writing and orally.
Possesses good customer services skill.
Ability to work in a focused manner with potential surrounding distractions.
Ability to work with minimum supervision.
Demonstrates reliability and self-motivation.
Ability to be a team player.

Education or Formal Training:

High School Diploma Required

Experience:

Prior experience with medical and insurance industry preferred.

Working Conditions and Other Conditions of Employment
Working Environment:
This job operates in a fast paced, professional office environment and routinely requires the use of standard office equipment such as computers, phones, and photocopiers. Most of the offices are open and modular in layout. Work may involve moderate exposure to ambient or loud noises. In the health center environment, there is potential for contact with blood-borne pathogens and communicable diseases, as well as potential for contact with dissatisfied or abusive individuals. There could be interaction with persons who are mentally ill, disabled, elderly and emotionally upset.
Physical Activities:
These are representative of those which must be met to successfully perform the essential functions of this job.
This is a largely sedentary role but can involve standing or sitting for extended periods of time, bending at the waist, and using hands and fingers to handle and file papers or operate assigned equipment. While performing the duties of this job, the employee is regularly required to talk or listen. Specific vision abilities required by this job include close vision, distance vision, color vision, and ability to adjust focus. Employee may also have to lift 10 to 25 lbs. unassisted.
Other Conditions of Employment:

Willingness to submit to mandatory random drug screening.
Willingness to accept temporary assignments and ability to drive to and from other office locations.
Reimbursement for mileage will be made at the current IRS rates.

Note: This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.