Billing Manager Coastal Eye Care

Description

Work closely with the Business/Billing Office Team Leader and Practice Manager while performing all components of Billing, Insurance Verification, and the Collections Process for existing and new patients. Supports the vision and mission of Covenant Surgical Partners through providing excellent customer service throughout the entire billing process.

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• As a Billing Specialist, you will take the data provided by the medical coders and use it to compile and submit claims to insurance companies.
• Utilize Athena-health Collector system to review first initial claim scrub and billing to the clearinghouse.
• Validate claims and make any corrections necessary to send out clean claims to the payers electronically and/or paper.
• Employ effective and efficient billing techniques, and self-directed initiative, to resolve all types of billing edits
• Conduct insurance verification and validation on all Coastal Eye Care and ASC scheduled patients to ensure eligibility and benefits are in order for accurate claim submission and payment.
• Communicate with patients in advance of their procedure regarding the patient' s financial responsibility (co-pay) due at the time of the procedure
• Act as the connections between the Front Desk staff, insurance verification and coding specialist to assist in the account billing resolution process and to escalate issues which adversely impact claims submission and payment.   
• Document accounts accurately and timely.
• Follow department policies and procedures defined by department as required to meet payer and regulatory requirements related to claims billing, payer rejections and clean claim submission including procedures related to release of information, record retention, privacy and confidentiality.
• Provide information to Billing Office Team Leader in identifying possible areas of concern that impact account billing or collections, accurately and in a timely manner.

Qualifications

EDUCATION AND/OR EXPERIENCE:

•  High school diploma or general education degree (GED).
• 1+ years in Healthcare Customer Service and Billing System from a Technical and Functional view (preferred).
• Must have working experience with all payer types: commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross over into different payers.
• Experience and ability to identify billing or payer edit opportunities within the billing system.
• Experience with Anesthesia, Ambulatory Surgery and Lab billing preferred, not required.
• Medical Billing Cenification preferred, not required

QUALIFICATIONS:

• Prefer candidate to have experience with CPT, ICD-IO, and NCCI coding, proficient in 10 key charge entry, experience with multiple types of insurance and reviewing the cards. Understanding of co-pay, coinsurance, and deductibles. Intermediate to expert experience in electronic claim submission and edit resolutions, third party payer insurance verification, collections and denial resolution process
• Word, Excel and Outlook experience is required. Ability to learn new programs and systems is required.
• Ability to read and evaluate Healthcare Receivables Information.

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