Specialty Billing Representative

Mid Atlantic Retina; Bethlehem (Northampton County); On-site; USD 40,000 - 60,000; Full time

Job summary

A leading healthcare organization is seeking a Specialty Billing professional to manage benefit verifications and patient accounts. The role involves ensuring proper billing procedures and effective customer service. Candidates should have relevant medical billing experience and proficiency with CPT codes and ICD-10, along with strong problem-solving skills.

Benefits

Medical

Dental

Vision

Sick Time

Vacation Time

7 Paid Holidays

Qualifications

• Experience with CPT codes and ICD-10 required.
• Knowledge of benefit investigation including obtaining eligibility information.
• Maintains high volume productivity level for essential functions.

Responsibilities

• Verifies all benefits for scheduled injection appointments.
• Obtains all necessary pre-authorizations for each patient.
• Acts as customer service representative for patient inquiries.

Skills

Problem Solving

Customer Service

Conflict Resolution

Detail Oriented

Time Management

Education

Medical billing experience preferred

Tools

Microsoft Office Suite

Job description

This position is eligible for Mid Atlantic Retina's $1,000 Hiring Incentive! The hired candidate will receive $500 after successful completion of 90 days of employment and $500 after successful completion of 1 year of employment! Available to new hires only- not available to agency hires, internal transfers, or re-hires.

Job Type: Full Time

Benefits: Medical, Dental, Vision, Sick Time, Vacation Time, 7 Paid Holidays and more

Job Description

Specialty Billing is responsible for verifying all benefits as they pertain to specialty drug injections and all the co-pay assistance funds. They are also responsible for following up with accounts receivable for any necessary payer.

Essential Functions

1. Verifies all benefits for scheduled injection appointments.
2. Evaluates all benefits for patient responsibility and notates accurate collection amounts.
3. Obtains all necessary pre-authorizations or pre-determinations for each patient to have treatment with a specialty drug.
4. Monitors all assigned schedules for add-ons and changes.
5. Assists in general billing AR when needed including but not limited to claims follow up, calls to insurances and anything necessary to obtain payment for all specialty drugs.
6. Recognizes, interprets, and evaluates inconsistencies, discrepancies, and inaccuracies in accounts along with system files, and initiates appropriate corrective methods.
7. Act as customer service representative in person or by telephone for any patient's questions about their account.
8. Maintain up to date billing knowledge of insurance carriers and their clinical policies.
9. Works overtime as needed.
10. Travels to other MAR locations as needed.
11. Performs other duties as assigned.

Competencies

1. Problem Solving / Analysis - Creative problem solving within defined acceptable parameters. Identifies and resolves problems in a timely fashion.
2. Customer Service- Superior listening skills, professional demeanor, and appropriate firmness.
3. Conflict Resolution- Responds promptly to customer needs. Ability to handle difficult patient interactions relative to sensitive billing issues.
4. Detail Oriented - Ensure proper procedures, protocols and processes are complied with consistently.
5. Strong Interpersonal Skills- Works effectively with patients, employees, and physicians.
6. Creative problem solving within defined acceptable parameters.
7. Time Management- maintains high volume productivity level for essential functions.
8. Ethical Conduct - Maintains confidentiality.

Required Education and Experience

1. Medical billing experience preferred.
2. Knowledge of benefit investigation including obtaining eligibility information, authorizations, and referrals.
3. Experience with CPT codes and ICD-10. Microsoft Office Suite required.