Job summary:

The Physician Billing Specialist is responsible for managing accounts receivables and perform work log/work queue tasks according to set standards and productivity measurements.

 Duties & Responsibilities:

• Provide professional and courteous service to all customers
• Communicate effectively in written and verbal form
• Maintain clean, well-organized, properly stocked and secure working area
• Maintain complete patient/employer confidentiality at all times per company and HIPAA requirements
• Perform job functions in accordance with current departmental Standards, Polices and Procedures
• Demonstrate teamwork by assisting coworkers with tasks/training as directed, and attending and participating in mandatory meetings
• Accommodates changes in workload within the department
• Keep supervisor informed when problems may interfere with work being completed on time
• Use initiative to resolve problems with appropriate action and follow through
• Review daily assigned tasks through the applications and as assigned according to department goals.
• Contact insurance companies, patients, and other third party payers regarding claims status and payment, via telephone and written correspondence according to established standards.
• Respond to inquiries and correspondence from insurance companies, patients, and other third party payers in a professional and timely manner.
• Refile/rebill claims as necessary, ensuring that all information contained on the claim is accurate and complete.
• Review and process denials from insurance companies, process for further review, identifying and initiating appeals as needed.
• Audit accounts for any necessary corrections, including updating coverage information.
• Maintain working knowledge of current procedural terminology, diagnosis codes, and insurance payer policies.
• Provide phone coverage for customer service related calls as needed.
• Works with patients to resolve outstanding insurance and/or patient balances according to set standards and policies.  This includes preparing accounts for collection.
• Set up payment plans with patients and follow up on all payment plans implemented.
• Performs at or above the assigned department quality and productivity standard