Company: Associated Retinal Consultants
Posted on: May 8, 2022
Associated Retinal Consultants, P.C. Position Description
POSITION: Medical Biller and Collections Analyst GENERAL
DESCRIPTION In a centralized billing department and under the
direction of the RCM COE Manager, the Medical Biller and
Collections Analyst ensures appropriate and accurate processes are
followed and secured to optimize reimbursement for services
rendered throughout Associated Retinal Consultants and Eye Care
Partners. Employee must maintain accuracy in preparing patient
billing statements and be able to accurately bill and collect for
most major insurance payer categories (Medicare, Blue Cross,
Medicaid, Commercial, HMO, Workman's Compensation, Nursing Home,
etc.) via electronic billing systems. Must demonstrate excellent
communication and negotiation skills, particularly when dealing
with patients regarding their billing statements. A high level of
professionalism and trustworthiness must be always exhibited. The
duties of a Medical Biller and Collections Analyst include making
collection calls, using payer websites, and generating
correspondence in a fast-paced, goal-oriented collections
department. DUTIES AND RESPONSIBILITIES -- Monitor, track and
correct claim denials and unpaid claims daily to ensure timely
processing of claims utilizing up-to-date electronic claims filing
procedures whenever possible. -- Maintain current knowledge of
retina coding guidelines including correct modifier use, ICD 10
coding and CPT/HCPCS use. -- Maintain a level of unpaid claims at
120+ days that are less than 5% of the total Accounts Receivable.
Reduce delinquency for assigned accounts.
- Clearly communicate to supervisor in a timely manner any issues
with payers, contracts, coding, or front office data input.
- Maintain current information regarding reimbursement
requirements for all payers needed to efficiently submit accurate
- Maintain and monitor assigned payer and patient accounts to
identify unpaid balances. Investigate historical data and seek
resolution. Reconcile customer disputes as they pertain to
outstanding balances. Activities will include customer calls,
account adjustments, small balance write-offs, customer
reconciliations, processing of credit memos and credit card
- Coordinate with clinic staff to obtain necessary documentation
needed to submit or appeal claims.
- Scan and import correspondence, documents, and other applicable
information into practice management/EMR programs.
- Maintain documentation in practice management system Notes and
Referral tabs regarding conversations with patients, payers,
pre-authorizations, pre-certifications, eligibility, and benefits;
this includes any tasks that are required from clinic staff to
ensure correct payment for procedures and specialty drugs.
- Correspond with patients regarding status of their accounts and
their responsibility for outstanding balances regardless of
insurance payers. Process payments and refunds and set up payment
plans during patient telephone calls.
- Provide exceptional customer service regarding collections
- Maintain accurate records and reports on collection activity,
update account status records, report on collection activity and
accounts receivable status.
- Coordinate information with Drug Reimbursement Specialist to
obtain proper claim denials to submit for vial replacement
coverage, if applicable.
- Act as liaison between all payers, patients, physicians, and
staff to answer any questions regarding insurance coverage and
resolve any outstanding claims.
- Build and maintain strong relationships with the third-party
payer community in addition to problem solving any issues
associated with processing claims.
- Complete assigned tasks and projects by established
- Investigate solutions to problems and determine best course of
- Work effectively in a team environment.
- Perform all other duties as assigned, which may include
assisting in other departments within Associated Retinal
- Minimal educational requirement: high school diploma
- Minimum of 2 years Medical Billing experience.
- Demonstrated ability to efficiently and effectively utilize the
Practice Management system capabilities i.e., running reports,
navigation of screens, modify patient accounts, etc.
- Excellent interpersonal and professional skills to work
effectively with others (teamwork) and provide superior customer
service to patients.
- Ability to handle confidential matters; adheres to all HIPAA
- Basic knowledge of 1500 claim form and understanding of payer
- Understand medical terminology, procedure codes and diagnosis
codes as they apply to insurance c
- Communicate clearly and professionally, both orally and in
writing with patients, team members, physicians, payers, and office
coordinators. Knowledge of correct and proper spelling,
punctuation, grammar, sentence structure, and English usage
- Ability to multitask duties, prioritize workload, organize
files and workspace and be self-directed in an open office
- Strong proficiency in MS Office Suite including Word, Excel,
and Outlook or other email system; use of computerized medical
billing systems; use of insurance websites; internet search
capabilities; and other applications as appropriate.
- Strong analytical and problem-solving skills. RELATIONSHIPS
Reports to: Reports to RCM COE Manager. Directly Supervises: Not
applicable Work Schedule: Varies, but typically Monday through
Friday. Potential for Saturday work hours depending on workload.
FLSA Status: Non-exempt WORKING CONDITIONS:
- Minimal physical activity (standing, bending, sitting, walking,
pulling, and lifting) for most of the work shift.
- Clean office environment.
- Possible hazardous chemicals. If you need assistance with this
application, please contact (636) 227-2600 Please do not contact
the office directly - only resumes submitted through this website
will be considered. EyeCare Partners is an equal
opportunity/affirmative action employer. All applicants will be
considered for employment without attention to race, color,
religion, sex, sexual orientation, gender identity, national
origin, and veteran or disability status.
Keywords: Associated Retinal Consultants, Novi , AR/RCM Specialist, Other , Novi, Michigan
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