The Billing Specialist performs the following duties as assigned.

1. Ensures all encounters are accounted for.

2. Review each encounter for accuracy.

3. Applies appropriate CPT & ICD-10 codes to encounter.

4. Review each patient account prior to input to ensure that patient account represents accurate payer source.

5. Answers patients’ questions concerning billing & corrects billing as needed.

6. Performs demographic data entry when possible.

7. Responds to patient telephone calls regarding account balances.

8. Researches aging analysis report to determine if unpaid claims must be re-filed or adjusted.

9. Takes necessary steps to ensure collection on unpaid claims. (Re-file, appeal, make corrections, etc.).

10. Conducts collection activities from patients, carriers or recommends account balance write off.

11. Immediately researches correspondence from carriers requesting a refund and provides information to Accounting Manager.

12. Processes refund to carriers after obtaining approval and instructions from Accounting Manager.

13. Reviews Daily Deposit to ensure accuracy and makes necessary corrections to logs.

14. Applies all payments received by mail to appropriate patient accounts.

15. Demonstrating flexibility, enthusiasm and willingness to cooperate while working with others in assigned inter-professional care teams to support PCMH programmatic activities.

16. Participate in population management activities, as directed.

17. Assist the care team by helping to measure quality and identify, refine and implement practice improvements that support the medical home, and assist in performance evaluation and quality improvement.

18. Apply the principles of comprehensive, community-based, patient-centered, developmentally appropriate, and culturally and linguistically sensitive care.

19. Performs all other related duties as assigned.