Vision Care Center Billing Specialist/Registration

Description

Vision Care Center - Estimated Start Date for position will be in October 2024

This position reviews accounts for assigned payers in order to reduce accounts receivables and enhance cash flow. This position is responsible for all aspects of electronic or paper claim submission. The position assumes responsibility for following proper insurance processes, timely follow-up and resolution of accounts, and provides feedback to management when internal problems resulting in nonpayment of claims are detected. Reports compliance issues from daily account review/payer information to management. Additionally, will provide a variety of services to patients from point of entry a timely, accurate, courteous and professional manner.

Account Review

• Reviews third party payment listings and takes appropriate action on accounts in order to avoid account aging and documents actions taken. Makes recommendations/decisions on account resolution. 
• Reviews assigned aged account receivable. Determines needed account follow-up. Makes recommendations and documentation to supervisor/director regarding overall work efforts. 
• Reviews and corrects billing and collection problems arising in patient care facilities requiring review of patient accounts, discovering errors, determining corrective action, and implementing correction.

Registration & Communication

• Greets and ascertains customer’s needs via telephone and in office.  
• Responds in an accurate, timely and complete manner to questions or directional needs. 
• Accurately completes registrations and pre-registrations for patients by entering demographic, financial, employment, referring Provider and Emergency contact information into computer system.  
• May request medical records and radiology exams prior to patient appointments. Obtains consent according to specified requirements.   
• Provides resource materials required by JCAHO, Corporate Compliance and Individual Departments.  
• Gives attention to the care and comfort of patients and their families.   
• Provides training to new employees utilizing the organization’s departmental policy and procedures.  
• Answers and triages incoming telephone calls and accommodates requests timely according to department processes.   
• Answers questions and provides information to caller within area of responsibility. 
• Apply a minimum of one health literacy method when communicating with patients/clients.

Claims

• Initiate collection with all insurance carriers on electronically submitted and/or paper claims. 
• Produces payment from third party payers to reduce account receivables as outlined by department. 
• Performs case evaluation, for sliding fee scale applications and contract compliance.

Billing

• Applies proper application of billing procedures to the various types of insurance carriers and their regulations. Reviews billing for accuracy and completeness. 
• Completes billing within timeframe outlined by department. Assists with posting mail receipts, Medicare, Medicaid, HMO and PPO payment listings against individual patient accounts. 
• Applies knowledge and understanding of Medicare and Medicaid regulations and billing, particularly as it applies to prevention of sanctions under Fraud and Abuse initiatives.

Information

• Acquires additional information needed by each payer. Responds to billing and collection questions, referral and certifications from all outside sources. 
• Patient contact may be needed to properly complete the requested information.

Training

• Participates in monthly training programs for staff on policies and procedures related to billing and collection, including proper coding, use of sliding fee scales, and financial screening. Will be responsible for training new team members as 
• Actively participates in process improvement. Accurately documents issues for management follow up when appropriate. Answers questions, identifies resources, and provides problem-solving solutions. Keeps manager informed of new problems or developments; assists in resolution

Cash Posting

• Assists with the proper posting of all paper and electronic payment listings and batches which must be posted within 72 hours including applicable contractual adjustments in accordance to managed care contracts. 
• Reconciles all cash posted amounts to the deposit amounts. Performs all posting functions according to departmental standards and meets departmental standards relative to productivity and quality.

Unidentified Payments

• Takes appropriate action to identify and resolve p