Medical Billing Specialist at Turbham Limited

DEPARTMENT/LOC: BILLING - DOWNTOWN
REPORTS TO: BILLING SUPERVISOR
PAY: N200,000 MONTHLY

The MEDICAL BILLING SPECIALIST performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of problems. Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies. May handle cash items and accounts receivable posting. Works with others in a team environment.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Processes billing to patients and third party insurance companies.
• Maintains supporting documentation files and current patient addresses.
• Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems.
• Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies.
• Resubmits claims to insurance companies as necessary.
• May receive and receipt cash items and third party reimbursements.
• Posts and reconciles payments to patient ledgers.
• Balances daily batches and reports.
• Maintains patient demographic information and data collection systems.
• Participates in development of organisation procedures and update of forms and manuals.
• Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine functions.
• Answers questions from patients, clerical staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Evaluates the patient's financial status and establishes budget payment plans.
• Follows and reports status of delinquent accounts.
• Reviews accounts for possible assignments to collections and makes recommendations.
• Performs various collection actions including contacting patients by phone,
• correcting and resubmitting claims to third party payers.
• Works in conjunction with the reception to ensure clean billing.
• Performs miscellaneous job-related duties as assigned.
• Participates in educational activities and attends monthly staff meetings.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Assists in development and communication of SOP for key areas to improve
• accuracy and understanding of processes.

QUALIFICATIONS & SKILLS:

• Minimum of 1 year of relevant experience and/or training, or equivalent combination of education and experience
• Basic Life Support Certification required.
• Strong knowledge of administrative and clerical procedures.
• Proficient in computers and relevant software applications and practice management technology.
• Possession of strong problem solving skills and sound judgment.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail and monitoring of work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills.
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgement.

PREFERRED EXPERIENCE:

• Prior medical billing and administrative experience in a private medical office.
• Customer service.

WORK ENVIRONMENT & PHYSICAL DEMANDS:

• Work is performed in an office setting.
• Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.

GENERAL SIGN OFF: The employee is expected to adhere to all company polices. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee.