The Medical Billing Specialist for Nurse Practitioners is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process, and posting cash receipts.
Essential Job Duties
- Extract and verify billing information from medical records
- Ensure collection of past due balances; follow up as needed
- Ensure all patient demographic and insurance information is accurate prior to submitting claims to insurance companies
- Answer patient account inquiries; assist in establishing alternative payment plans when necessary
- Maintain patient account records; settle third-party payer issues as required
- Receive and review Daily Reconciliation Review (DAR) documents for accuracy; enter charges into the Practice Management System (PMS)
- Prepare and review patient statements prior to release through PMS
- Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims
- Balance daily charges and reconcile with reports within PMS
- Collaborate with the revenue cycle manager and payers on denials/rejections
- Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained
- Other duties as assigned
Requirements & Qualifications
Qualifications and Requirements
- Comply with applicable legal requirements, standards, policies, and procedures, including those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and the Federal False Claims Act
- Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
- Communicate professionally with patients and guarantors regarding balances or account information
- Participate in required orientation and training programs
- Cooperate with monitoring, audit functions, and investigations
- Participate in process improvement responsibilities
- Meet productivity goals
- Successfully complete required training
- Handle multiple priorities effectively
Required Skills
- Problem-solving skills to manage a variety of concrete variables
- Effective verbal and written communication skills
- Ability to interpret instructions presented in a variety of situations
- Strong organizational skills and ability to manage multiple projects simultaneously
- Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
- Ten-key speed and accuracy
Location
Tennessee, US
Employment Type
Full-time
Remote work allowed
No
Posted
1 month ago