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Medical Billing Clerk

Elmira, NY 14904

Posted: 04/07/2020 Industry: Medical Billing Clerk Job Number: 130318

Job Description

Job Description: Billing Specialist, Home Medical Equipment
Reports to: Manager
Status: 40 hrs./week, Monday thru Friday; Rotate monthly between 8: 30am-5: 00pm and 9: 00am-5: 30pm; must work 1-2 Saturdays a month

Overall: Must be an enthusiastic candidate who truly loves helping people! Must be intensely passionate about helping those with disabilities, injuries, and illness obtain products and services to meet their medical necessity

Duties include:
Providing exceptional customer service by:
Talks with customers by phone or in person and receives orders for delivery, pick-up, discontinuance, maintenance or changes in service.
Takes necessary information from referral sources to evaluate services being ordered
Fills out order forms, determines products needed for service requested, collects co-pays, and inserts data into information system.
Interviews patients, caregivers, referral sources to assess the needs for new or additional services.
Processing Insurance Verification and Eligibility Reviews for Requested Services and Equipment
Identify deductible, coinsurance, and copay amounts
Identify the need for prior authorization of products and services requested
Obtain the necessary documentation and file appropriate forms to process authorization requests
Once approved, enter order request into system and outline coverage
Ensure all proper dispensing Ensure all proper billing methods are followed by:
Obtain all required documentation and completed prescriptions prior to submitting a claim
Ensure that the customer has received the requested items prior to submitting a claim
Ensure proper prescription refills and renewals are obtained prior to submitting a claim
Ensure all proper compliance data is obtained as appropriate prior to submitting a claim
Ensure optimal Cash flow by:
Working incomplete orders
Working held orders
Other duties include:
Set up new customer files/ Scanning Patient Files
Answering phones
Complete and accurate Intake
Saturday and/or on-call rotation
Other duties as assigned
High School Education or GED at minimum
Experience with Medical Billing, Insurance Verification, and Authorization Processes preferred
Willingness to learn and take initiative
Proficient with basic software applications (Word, Excel, Outlook)
Basic cash and report reconciliation
Highly organized
Candidates must be able to successfully pass background check, as indicated.
Must have these qualities:
High level of attention to detail
Exceptional communication skills
Team collaboration
Sales team interaction
Positive influence on teammates
Innovation and thinking outside the box
Able to manage multiple priorities and close the loop when interrupted
Must maintain a high level of internal customer service
Problem solving and conflict resolution
Working Environment:
Constant communication with multiple staff
Constant communication with insurance companies
Occasional communications with customers in person and on phone as well as with other team members
Must be able to work phone, fax, computer, printers
90% of time spent sitting in back office environment on computer and on phones, 10% assisting customers in retail environment

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