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Billing Specialist


Type of Position

Business Office

Full-time, 40 hours/wk.

As a Billing Specialist for Medical Center Eye Clinic, you will be accountable for accurate monitor billing, billing secondary claims and AR work (ODS, HealthNet, Pacific Source and Care Oregon). You will be responsible for providing exceptional customer service by explaining charges, payments, and balances to patients as well as working out payment arrangements. You will be expected to keep up to date with carrier coding and contract changes, benefit and plan cover-age information.

You must have a HS diploma or equivalent to qualify for this position. A clear understanding of ICD-9/ICD-10 and CPT codes is also required. It is preferable to have one or more years of successful experience with medical and/or hospital billing.

  • Excellent interpersonal, communication, telephone, customer service, organizing, and time management skills are essential.
  • Creatively resourceful with a clear understanding of fee schedules, eligibility records, commercial carriers, PPO’s, MCO’s , Medicaid, Medicare and reimbursement trends.
  • Possess a high level of analytical, critical and forward thinking skills with using balanced judgment.
  • Billing experience with extensive knowledge of ICD-9 and ICD-10 and CPT coding.
  • Proven ability to research and analyze claims and complex payer issues and reimbursement policies.
  • Intermediate level of Excel experience including precise data mining and manipulation, creating spreadsheets and tracking data.
  • Self-motivated & can multi-task easily.
  • Consistent output of high quality of work with paying precise attention to detail and accuracy.
  • Well-versed with understanding EOB’s and payments, adjustments and response codes.
  • Ability to read, write, speak and understand English.
  • Ability to perform basic Math.
  • Ability to actively participate in team oriented processes.
  • Physical ability to use computer hardware/software required.
  • Supports and contributes to effective safety and risk management efforts by adhering to established policies and procedures, maintaining a safe environment, promoting accident prevention and identifying and reporting
    potential liabilities.
  • Coding and Posting Monitors
  • Prepares and bills Secondary Claims both electronically and paper.
  • Keep informed and identify new or coding changes and assess reimbursement trends and inform supervisor, providers and billing team of specific payer updates.
  • Identify codes/services that should be negotiated in contracting.
  • Maintain all records/work so they are accessible to the billing team and Practice Manager.
  • Willingly share knowledge, findings recommendations and maintain open, friendly and respectful communication with coworkers, patients and management.
  • Back up billing team in all aspects.
  • A/R: Follow up on accounts timely and accurately. Reduce aging by being proactive and working with payers to resolve issues.
  • Customer Service: Calls are answered timely, professionally and respectfully. Applies good listening skills as well as problem solving skills. Accounts are notated thoroughly. Thorough analytical skills while resolving patient complaints, concerns and account maintenance.
  • Continual talking to people in person or on the telephone. Occasional communication via e–mail.
  • Continual hearing in person and on the telephone.
  • Vision for close work.
  • Ability to sit and operate a computer for long periods of time.
  • Noise level consistent with that of a busy medical office setting in a “high traffic” are within the office.

You will be expected to understand and adhere to environmental needs of the office, including:

  • Safety requirements (i.e. clothing, equipment required, activities performed) consistent with that of a medical office setting.
  • Exposures (i.e. fumes, chemicals, vibrations, humidity, cold, heat, dust noise, blood & body fluids) consistent with that of a medical office setting.
  • Operation of equipment, tools, vehicles consistent with that of a medical office setting.
  • Required hygiene standards (food handling, clean, contaminated and sterile equipment) consistent with that of a medical office setting. Medical Center Eye Clinic strives to keep a fragrance-free environment to benefit those with allergies.

You will report weekly to the Practice Administrator, more often as needed. The Billing Specialist works closely with billing department coworkers to determine payment, billing, and reimbursement issues, and with all staff, patients, management, providers and outside vendors providing assistance and information as requested. From time to time, Medical Center Eye Clinic staff members may be asked to participate in a Quality Improvement project in addition to their typical job functions.

This job description is intended to describe the general content of, and requirements for this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements, and does not limit the assignment of additional duties at the discretion of the manager or supervisor. It may be used as a tool during future performance evaluations.

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