Robert Half Medical Payment Poster Specialist in Dallas, Texas
Description Patient Billing Rep
Overall responsibility for contacting all assigned patient and insurance/third party payer accounts with a debit balance to ensure receipt and processing of claim within 45 days from the date of service. Perform appeals for underpaid claims or claim denials as assigned by the Billing Manager. Procure payment or establish payment arrangements with patients and/or guarantors in accordance with business office policies and procedures.
Principal Duties and Responsibilities:
• Works a detailed daily work queue for assigned accounts over 31 days old.
• Works detailed aging report as assigned for accounts over 31 days old.
• Audits assigned accounts for proper insurance filing. Compares posted payments to EOBs to confirm proper patient balances prior to patient collection attempts.
• Keeps up-to-date on vital contract information concerning assigned payers to establish proper and timely payment of claims.
• Determines average claim entry, processes timeframes for assigned payers, and determines the status of unpaid claims beginning from the 45th workday from the date of service.
• Responsible for using Replica to extract needed EOB’s or zero pay EOB’s when needed.
• Utilizes approved appeal form letters to submit appeals in accordance with billing office policies and procedures.
• Forwards medical or coding denials to the QA Department for nurse review and appeal.
• Demands claims for secondary insurance filing and copies explanation of benefits in accordance with business office policies and procedures.
• Procures applicable payment from patients, or establishes payment arrangements not to exceed 120 days from the date of service.
• Skip traces accounts according to established practices.
• Reviews payment arrangement accounts that have not had regular payments in over a month.
• Initiates collection letters and/or statements to patients in accordance with business office policies and procedures.
• Responsible for neatness of work area and security of patient information in accordance with the Privacy Act of 1974 and the Health Information and Portability Act (HIPAA).
• Works with Manager and Compliance Committee to ensure Compliance Program is followed.
• Performs other duties as assigned or requested.
Knowledge, Skills, and Abilities:
• Has a working knowledge of the Fair Debt Collection Act and state and federal laws applying to collection activities.
• Excellent verbal and written communication skills, interpersonal skills, analytical skills, organizational skills, math skills, accurate typing and data entry skills.
• Ability to deal professionally, courteously, and efficiently with the public.
• Treat all patients, referring physicians, referring physicians’ staff, and co-workers with dignity and respect. Be polite and courteous at all times.
• Knowledge of all confidentiality requirements regarding patients and strict maintenance of proper confidentiality on all such information.
• Knowledge of medical terminology, CPT and ICD-10 coding, office ethics, and spelling.
• Must be computer literate.
• Must possess knowledge and understanding of managed care and insurance practices.
Education and Experience:
• High School graduate, technical school, or related training preferred.
• Accounts Receivable and collection experience.
• One-year work experience in a medical office or equivalent. Requirements EMR - Electronic Medical Records, Medical Payment Poster, Outpatient Coding, Patient Accounting, Patient Appointments, Patient Billing, Patient Balance, EOB - Explanation of Benefits, EOB, Import Export, Electronic Remittance, Remittance, Remittance Advice, HIPAA Compliance - Patient Privacy Rule, HIPAA Compliance - Sys Implementation, HIPAA-Regulated, CPT 4, CPT Codes, CPT Hcpcs Codes, CPT-4, ICD CPT, ICD-9 CPT-4, ICDM CPT, ICD-10
Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.
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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.