Billing Representative – Payments and Collections

Job Title:                    Billing Representative  – Payments and Collections

Location:                    Billing Office/Department                                                      

Reports to:                 Billing Supervisor

Exemption Status:  Non-Exempt         

SUMMARY – The purpose of this position is to perform all aspects of third party radiology billing.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Prepare and complete the daily remote bank deposit.
• Accurately record and post all guarantor and insurance electronic fund transfers, credit cards, cash, and check payments to patient accounts in Intergy
• Identify and resolve all guarantor or insurance credit balances. Credit balances are resolved by issues a refund check, return to credit cards, or submitting a written request to the party who overpaid.
• Download and reconcile electronic remittance advice(s) and manually record and post any exception payments.
• Identify and resolve recoupments or recalled payments from insurance carriers.
• Complete written inquiries/correspondence to insurance carriers about denied/unpaid claims.
• Maintain the recording and updating of collection actions or features in the Intergy Collection Module for delinquent and past due accounts.
• Work the Intergy insurance claim control queue to resolve and correct front end rejections, as well as tracking past due claims.
• Use Practice Analytics program to create Excel spreadsheets to track and work unpaid claims for assigned insurance carriers.
• Use Navinet or other electronic websites to verify insurance eligibility, cost share, and claim status.
• Provide support and payment plan options to callers who are unable to pay estimated cost share or account balances.
• Contact guarantor or patient to resolve past due in-house or collection agency balances.
• Communicate with provider representatives and collection agencies to resolve unpaid claims or balances.
• Answer Billing office phone and que calls as assigned by supervisor in a timely manner while being courteous and professional to callers. Escalate phone calls to supervisor and/or management as needed.
• Complete assigned work on a daily basis meeting productivity for the number of payment posting, account inquiries, and phone calls.
• Present employee errors in accounts to supervisors and/or management for review.
• Maintain a cooperative, pleasant attitude and working relationship with coworkers and management.
• Maintain confidentiality and comply with all HIPAA and Corporate Compliance regulations
• Punctuality and regular attendance
• All other duties as assigned

SUPERVISORY RESPONSIBILITIES – This position has no supervisory responsibilities

QUALIFICATIONS

• High school diploma or equivalent
• Proficient computer skills

Training and Experience

• Two (2) or more years experience in accounts receivable resolution is required.
• Well rounded with an understanding of all functions of billing processes including; but not limited to, basic knowledge of medical terminology, reimbursement analysis, experience with appeals process, credit balances, billing regulations, etc.

Knowledge, Skills and Competencies

• Current, thorough working knowledge of physician third party billing regulations, processes, electronic billing, etc.
• Ability to perform mathematical calculations
• Knowledge of ICD-10 and CPT coding
• Proficient with computer spreadsheet skills
• Excellent interpersonal communication skills including oral and written
• Working knowledge of business office equipment (i.e. fax machine, copier, keyboard, mouse, etc)

Physical Demands of the Position – The position requires sitting for 75% of scheduled shift as well as walking, standing, reaching and lifting folders or boxes (less than 25 pounds). Continuous use of computer keyboard, computer mouse and multiline telephone is required during scheduled shift. Using stairs and/or elevator to enter and exit Billing department.

Working Conditions – The position is performed in an indoor setting in close proximity to coworkers.

Disclaimer – The preceding job description was designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

Interested candidates can submit their resume at resumes@sjra.com. Please include the Job Title, Location, and Hours in the subject or body of your email.