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GI Care for Kids · 1 day ago

Billing and Collections Specialist

Atlanta, GA

Full-time

Onsite

Mid Level

3+ years exp

GI Care for Kids is a healthcare organization seeking a Billing and Collections Specialist. The role involves managing accounts receivables, ensuring timely follow-ups with insurance companies, and communicating effectively with patients and staff to facilitate the collection of payments.

Child CareHealth CareOutpatient Care

Responsibilities

Follow up on all accounts within the timely filing guidelines of the insurance company assigned to the biller

Correcting claim issues, and/or rebilling claims to third party payers. Claims must be corrected and rebilled within the timely refiling guidelines of the insurance company assigned

Write appeal letters

Communicating with all departments, i.e., front desk staff, nursing and providers to ensure appropriate collection of co-pays and self-pay balances prior to patient visits

Contact patients after obtaining auth to discuss collection of out-of-pocket expenses prior to patient visits

Documenting the appointment desk, calling guarantors and communicating balances that need to be collected

Handles inquiries and answers questions for clerical staff, clinical staff, and insurance companies within a 24-hour turnaround time

Daily monitoring of assigned insurance A/R’s, statuses on delinquent self-pay accounts, and all assigned WQ’s

Meets deadlines of completing all assigned WQ’s prior to the end of the month

Identifies and resolves patient billing questions in the office and incoming calls to the business office

Daily collection and/or posting payments from insurance companies and patients as assigned daily

Reviews accounts and makes recommendations regarding non collectible accounts when working delinquent and collection accounts

Notifies manager of non-collectible self pays and insurance balances

Verifies patient eligibility through various third-party sources

Understands patient benefits from various all insurance carriers and determines out of pocket and in and out of network status prior to visits in the office

Documents payments collected, A/R, and phone call resolutions in software system

Understands fee schedules and updates manager of fee schedule changes and effective dates timely

Monitors changes in policy and fee schedules for all insurance carriers assigned and informs manager

Answers business office phone calls daily and on a rotating weekly schedule

Explain out of pocket expenses to guarantor

Assist in the enrollment and explain drug rebate programs such as Care Path and Entyvio Connect and Pfizer

Assist patients in completion of paperwork, explain and follow up patient assistance programs when needed

Communicate effectively with professional staff and patients

Daily monitoring of personal business office phone line, business office phone calls and emails

Ensures voicemails are returned within a 24-hour time period

Responds to all emails and staff messages from manager, staff and patients in a 24-hour time period

Daily collection of business office mail, and routing to appropriate billers

Filing of manually posted payments

Cross trained to fill in for other job functions on an as needed basis

Additional duties as assigned by management

Qualification

Medical Billing CertificationMedical PayersEpic Billing SystemCPTICD-10 CodingCustomer Service OrientationMicrosoft Office SuiteAnalytical SkillsOrganizational SkillsInterpersonal SkillsProblem Solving