Billing & Collections Specialist I

US-Oral-Surgery-Management; Irving (TX); On-site; USD 25,000 - 33,000; Full time

Job summary

U.S. Oral Surgery Management is seeking a detail-oriented RCM specialist to manage patient and insurance balances, follow up on claim status, and research denials. You will communicate with patients, practices, and insurers to maximize reimbursement and document all account activities.

Qualifications include a high school diploma or GED, excellent communication, and proficiency with patient management software. On-site Irving, TX employment with growing dental network.

Qualifications

• High School diploma, GED, or equivalent.
• Experience in a medical and/or dental environment is a plus.
• An equivalent combination of education and experience is acceptable.

Responsibilities

• Follow up with insurance and patient balances, including claim status and denials.
• Contact patients to discuss outstanding balances when denied by insurance.
• Communicate with practice partners, coworkers and insurers to maximize reimbursement.
• Utilize billing systems to manage patient accounts and postings.
• Prepare statements and emails, maintaining records of sent statements and billing communications.
• Run weekly aging reports and monitor buckets for outstanding claims.

Skills

Communication

Problem-solving

Team player

Computer proficiency

Education

High School diploma/GED

Tools

Patient Management Software

Job description

The following position is for employment with:U.S. Oral Surgery Management500 E John W Carpenter Fwy #300, Irving, TX 75062POSITION PURPOSE:The primary duties and responsibilities include the ability to follow up with insurance and/or patient balances which include obtaining claim status, researching rejections and denials, and documenting related account activities. Actively reach out to patients to discuss outstanding balances when denied by insurance and collect balances. Communicate with and support other RCM staff patients, partner practices and insurance companies to maximize reimbursement and ensure rapid account resolution.PRINCIPAL RESPONSIBILITIES AND DUTIES:Communicate with patients, practice partners and coworkers by answering telephone, emails messages and TEAMs messages to assist with any questions or apprehensions regarding balances, billing, collections and reimbursement.Utilizes MY Transworld Health website to send patient accounts to profit recovery and collections. Updates My TSI with additional information regarding patients’ failure to pay remaining balances if patient submits a dispute.Send email with statements to update patients on remaining balances and bad debt.Maintains a record for practice with all sent statements and emails regarding billing to patients.Updates billing systems to reflect status of collection and patient payments.Identifies possible issues or concerns that may impede insurance/patient payments and collaborates with manager to construct a resolution for issue.Provides a thorough explanation of benefits to patients, and properly explains reasoning behind balances and collections.Runs aging report weekly, monitors bucket which includes money in insurance claims that still needs to be collected and follows up with insurance to find reasoning behind outstanding, rejected or pending claims. Reviews errors and provides resolution to issues. (Manager may assign report via email)Initiates review of patient accounts with credit balances and issues refunds when necessary.Ensures insurance pays correctly and issues adjustments following state law and USOSM protocol.Create contact notes with reminder dates to ensure claims are follow- up on timely.Pulls zero pay and applies insurance adjustment, updating billing category.Follows appropriate procedures before moving patients balance to collection agency.Processes/or gives to poster any credit cards when taken over the phone.Communicates with practice on accounts needing discretionary adjustments posted.Must maintain the accuracy rate determined by manager while training and then maintain 96% or betterPerforms additional duties as assigned by manager or director.MINIMUM QUALIFICATIONSBasic Knowledge & Competencies:Ability to manage multiple priorities with frequent interruptionsExcellent oral and written communication skillsAbility to meet deadlinesProblem-solving skillsExceptional human relations skillsMust be a team playerProficient in use of computers and Patient Management SoftwareAdding and subtracting math skillsPrevious Experience/Education:High School diploma, GED or equivalentExperience in a medical and /or dental environment a plusAn equivalent combination of education and experience is acceptablePHYSICAL REQUIREMENTSWhile performing the duties of this job, the employee is regularly required to sit for prolonged periods. Occasional lifting and bending to carry boxes and supplies, up to 25 pounds, may be required.