GENERAL SUMMARY OF DUTIES: Primary responsibility is maximizing reimbursement by resolving

billing and claim issues with both patients and payers. This will specifically be done through Accounts Receivable resolution.

ESSENTIAL FUNCTIONS:

• Actively review Payer A/R to ensure claims are accurate and billable.
• Identify and resolve claim edits through understanding of billing guidelines and payer requirements
• Proactively fix claim rejection errors and resubmit claims based on payer requirements
• Comply with all government and third-party payers regulatory mandated requirements for billing and collections
• Ability to maintain confidentiality of all information under HIPPA guidelines
• Ability to be self-directed, coupled with exemplary time management skills and the ability to manage multi-tasking
• Other duties as assigned - such as, but not limited to, answering patient calls and being a resource to other departments

EDUCATION:

• High School Diploma or GED

EXPERIENCE:

• Two years' experience in medical accounts receivable resolution, preferably in a physician office.
• Orthopedic experience beneficial but not necessary

KNOWLEDGE

• Knowledge of medical billing practices and office policies and procedures.
• Knowledge of insurance
• Knowledge of all confidentially requirements regarding patients and strict maintenance of proper confidentiality on all such information.
• Knowledge of medical terminology, basic anatomy and physiology
• Knowledge of grammar, spelling and punctuation

SKILLS

• Skill in operating computers, calculators, copiers, printers, fax machines, and telephones
• Excellent math skills
• Excellent communication skills, both written and oral
• Must possess tact and diplomacy
• Must possess enough manual dexterity to perform the essential responsibilities to meet customer needs effectively
• Demonstrates initiative to provide quality of services and improve efficiency
• Maintains positive working relations with co-workers
• Time management skills

ABILITIES

• Ability to deal professionally and courteously, and efficiently with the public and to remain calm under stress.
• Ability to understand and interpret policies and regulations.
• Ability to prepare documents in response to complaints and inquiries
• Ability to examine documents for accuracy and completeness
• Ability to communicate effectively in the English language

ENVIRONMENTAL/WORKING CONDITIONS

Work is performed in an office environment. Involves frequent phone contact with the public. Work may be stressful at times. Contact may involve dealing with angry or upset people.

PHYSICAL/MENTAL DEMANDS

Work requires hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands, or sitting for extended periods of time. Must possess visual and auditory acuity in order to communicate with co-workers, patients and other customer groups. Possible exposure to chemical hazards. Must be able to lift to 25 lbs.