Job Details
Description
This position is primarily responsible for collecting, posting and managing account payments. The Lab Billing Specialist enters appropriate information into the database, generates patient invoices and resolves patient billing inquiries and issues.
Primary Duties and Responsibilities:
· Under direction and supervision of the Controller, responsible for managing patient account payments and records promptly, accurately and with impeccable attention to detail.
· Posts charges, payments and adjustments in billing databases to include, but not limited to Daily Batches, Egg Donor Agency Batches, Embryo and Sperm Cryopreservation Batches, Mail Batches, and Lab Charge Batches.
· Resolves routine patient billing, payment and collection issues and expedites complex or unusual issues to Controller for resolution.
· Maintains strictest confidentiality and adheres to all HIPAA guidelines/regulations.
· Creates patient records, billing and financial documents and makes other entries in the NAV database.
· Prepares and submits clean claims to various insurance companies. Determines, corrects and submits billable claims.
· Completes insurance data for patient claims, including correct amounts, CPT and diagnosis codes.
· Processes, researches and corrects accounts; verifies diagnosis and authorization codes; identifies liability and guarantors, conducting research in cases where the guarantor is unclear; reviews and adjusts account balances; interprets Explanation of Benefits (EOBs) from insurance companies.
· Tracks status and confirms receipt of claims.
· Reconciliation of accounts.
· Conducts monthly audits
· Answers questions from patients, PFC staff, insurance companies and others.
· Identifies and resolves patient billing complaints.
· Prepares, reviews and sends patient statements when requested.
· Follows and reports status of delinquent accounts to Controller.
· Processes payments from insurance companies.
· Processes patient and insurance refunds and credit card payments.
· When required, performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
· Participates in continuing educational activities and attends monthly Team meetings.
· Performs other duties as assigned.
Education and Experience:
· High school diploma or equivalent required; some college preferred.
· 1-2 years experience working in a medical office performing medical billing processes.
· Knowledge of medical billing and accounting procedures and applications.