About this role
This position is eligible for Mid Atlantic Retina's $1,000 Hiring Incentive! The hired candidate will receive $500 after successful completion of 90 days of employment and $500 after successful completion of 1 year of employment! Available to new hires only- not available to agency hires, internal transfers, or re-hires.
Job Type : Full Time
Benefits: Medical, Dental, Vision, Sick Time, Vacation Time, 7 Paid Holidays and more
Job Description
Specialty Billing is responsible for verifying all benefits as they pertain to specialty drug injections and all the co-pay assistance funds. They are also responsible for following up with accounts receivable for any necessary payer.
Essential Functions
- Verifies all benefits for scheduled injection appointments.
- Evaluates all benefits for patient responsibility and notates accurate collection amounts.
- Obtains all necessary pre-authorizations or pre-determinations for each patient to have treatment with a specialty drug.
- Monitors all assigned schedules for add-ons and changes.
- Assists in general billing AR when needed including but not limited to claims follow up, calls to insurances and anything necessary to obtain payment for all specialty drugs.
- Recognizes, interprets, and evaluates inconsistencies, discrepancies, and inaccuracies in accounts along with system files, and initiates appropriate corrective methods.
- Act as customer service representative in person or by telephone for any patient's questions about their account.
- Maintain up to date billing knowledge of insurance carriers and their clinical policies.
- Works overtime as needed.
- Travels to other MAR locations as needed.
- Performs other duties as assigned.
Competencies
- Problem Solving / Analysis - Creative problem solving within defined acceptable parameters. Identifies and resolves problems in a timely fashion.
- Customer Service- Superior listening skills, professional demeanor, and appropriate firmness.
- Conflict Resolution- Responds promptly to customer needs. Ability to handle difficult patient interactions relative to sensitive billing issues.
- Detail Oriented - Ensure proper procedures, protocols and processes are complied with consistently.
- Strong Interpersonal Skills- Works effectively with patients, employees, and physicians.
- Creative problem solving within defined acceptable parameters.
- Time Management- maintains high volume productivity level for essential functions.
- Ethical Conduct - Maintains confidentiality.
Required Education and Experience
- Medical billing experience preferred.
- Knowledge of benefit investigation including obtaining eligibility information, authorizations, and referrals.
- Experience with CPT codes and ICD-10. Microsoft Office Suite required.