Allscripts Billing Specialist

• Veradigm EMR Systems used to be Allscripts not a hard requirement
• Candidates should have a solid understanding of medical billing and coding but does not need to be a medical coder
• Understanding of Medicare/Medicaid claims processing and third party payer procedures
• Candidates with prior experience in handling insurance denials and posting charges/payments would be ideal

Job Summary:
Reviews billing data from medical office records to ensure amounts and account numbers are accurate, responsible for account posting, collections, and verifying patient benefits. Responsible for accurate diagnosis and procedure coding.

Essential Functions:

• Responsible for verifying and posting charges.
• Responsible for posting and monitoring payments from patients.
• Answers patient questions regarding their accounts and insurance coverage.
• Contacts insurance companies to verify medical insurance coverage for patient and to obtain information concerning extent of benefits. Determine patient s payment responsibility for procedures.
• Research and correct all insurance denials.
• Identify delinquent accounts, aging period and payment sources. Processes delinquent unpaid accounts by contacting patients and third-party payers.
• Perform various collection actions including contacting patients by telephone and/or letter and resubmitting claims to third-party payers.
• Evaluate patient financial status and establish payment plans. Follow and report status of delinquent accounts.
• Review accounts for possible assignment to collection agency or other account determination.
• Oversee claim processing to include audits and review of claim payments for accuracy and compliance with contracts.
• Help patients with Patient Assistance programs.
• Responds to patient/payer inquiries in a timely manner
• Follows up on unpaid or improperly paid claims as necessary
• Reviews and monitors select accounts within the accounts receivable
• Ensure patient confidentiality and follow HIPAA guidelines.
• Promote a professional image by adhering to the established dress code as listed in Employee Handbook.
• Check and resolve assigned tasks in EMR program.

Performance Requirements:

Knowledge:

• Knowledge of medical billing and collection practices.
• Knowledge of basic medical coding.
• Knowledge of third-party payer operating procedures and practices.
• Knowledge of Medicare requirements.