PI Billing Representative

Description

GENERAL DESCRIPTION/POSITION GOAL: Under the direct supervision of the Billing Supervisor

JOB RELATED FUNCTIONS:

Demonstrates competency in the performance of job related skills appropriate to his/her customer populations and departmental services.

Work closely with the Supervisor to evaluate and rectify billing issues.

Duties include, but are not limited to;

Research systems to provide updated demographic information

Patient billing

Review accounts in billing system to verify claim handling was appropriate

Research patient inquiries and provide information to manager regarding the handling of the patient's account and launch case investigations with billing service to instruct on proper account handling (i.e. appeals to be filed with insurance, claims handled incorrectly, etc.).

Launch case investigations with billing service to instruct on proper account handling (i.e. appeals to be filed with insurance, claims handled incorrectly, etc.)

Handle attorney inquiries and provide information to attorney's regarding their client account

Report any trending errors/issues to the Supervisor

Use coded data to produce and submit claims to insurance companies using CMS 1500 forms

Work directly with the insurance company, representing attorney and patient to get a claim processed and paid, such as verifying the date of accident, claims address and adjuster information.

May be responsible for or assist in new employee training

Answer patient billing questions

Handle collections on unpaid accounts

Duties/special projects as assigned

Conducts special projects as assigned

HIPAA compliant in all aspects of the positions

Promotes HIPAA compliance

CUSTOMER SERVICE EXPECTATIONS: Demonstrates competencies in customer service and an understanding SimonMed Imaging code of conduct and culture.

EQUIPMENT: Utilizes and operates equipment and mechanical devices which provide for a functional, effective, and safe environment.

JOB RELATED AND PROFESSIONAL GROWTH: Adheres to policies, procedures, guidelines relative to departmental operations. Participation in specific activities for the promotion of self-growth or the enhancement of a positive image.

QUALITY: Applies the standards of practice/performance in the work setting to achieve positive outcomes.

MINIMUM QUALIFICATIONS: Must have High School diploma with one or more years of experience. Must have knowledge of HIPAA guidelines, experience with Microsoft Word and Excel. Knowledge of Medical Billing is a plus. Must be able to communicate effectively with attorneys, physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers. Must be proficient in telephone etiquette. Preferred Qualification: Experience in company accounts.

PHYSICAL DEMANDS: This position may require duties including lifting and carrying up to 40 pounds, sitting for prolonged periods of time, with frequent standing and walking. Good visual and auditory acuity as well as good manual dexterity and the ability to be readily understood are essential. Must be able to work in an environment with multiple deadlines and priorities. Must be able to work in a stressful environment.

DRESS ATTIRE: Business/Administrative wear.