DEPARTMENT: Business Office
REPORTS TO: Administrator
JOB SUMMARY: This individual is responsible for managing all billing activities within the
practice along with collection responsibilities and details listed below.
Other duties as assigned by the Administrator and Physicians of the clinic
at any time.
EDUCATION AND EXPERIENCE:
1. High school diploma or equivalent.
2. Two years supervisory experience in a medical office.
3. Five years’ experience in billing.
4. Certified Ophthalmic Coding designation desired.
ESSENTIAL SKILLS AND ABILITIES:
1. Computer literate including knowledge of Microsoft® Word.
2. Bookkeeping skills and a working knowledge of NextGen medical billing software.
3. Understanding of Medicare/Medicaid/Private Insurance rules and regulations and CPT and
4. Good communication skills with patients.
1. Financial Responsibility
a. Oversees entire billing department staff and all of its processes.
b. Ensures all encounters are billed in less than 7 days.
c. Reconciles all cash transactions daily.
d. Formulates bank deposits on an as needed basis.
e. Posts all insurance payments daily.
f. Maintains a monthly account of receivables over 30, 60 and 90 days, seeing that over-90 days are called on and followed up.
g. Reconciles credit card balance daily.
h. Remedies any previously approved insurance claim that has subsequently been denied through the full payment process to ENSURE payment – notifying Business Office Manager and Administrator of outcome.i. Handles and delegates all patient complaints and questions regarding billing in a timely and consistent manner.
j. Fully manage and work AR Report weekly in conjunction with Office Manager and Administrator and other billers.
k. Review Unbilled Report Daily
l. Manage Collections process and manage efficiencies within with Office Manager and Administrator.
m. Oversee all preauthorization and referral processes.
n. Write and develop SOP and Process Manual for Billing Department and maintain.
o. Work with other managers to develop process improvements within the clinic.
p. Manage all appeals and follow through with billing team on a timely basis. Reports on these would be sent to the Office Manager and Administrator for review weekly or upon request.
q. Adjustment reports and write offs reviewed and adjustments approved per the Billing Supervisor and Administrator daily. Signatures required from Administrator for approval.
r. Actively involved in the chart review process
s. Actively delegate or call on benefits and notify patients ahead of time on patient balances due
t. Reformat the collection process to be more proactive in conjunction with the Business Office Manager and Administrator
u. Other Duties As Assigned