Billing Specialist
Candescent Eye Management - Koch Eye - Warwick, RI

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The Billing Specialist is responsible for coordinating all activities to ensure accurate billing and reimbursement for all services. The Billing Specialist sets standards and oversees compliance with front end revenue cycle activities including, but not limited to, verification of insurance, point of service collections, collection of billing specific patient data, authorizes/referrals for services, coding and documentation standards for clinical staff, accurate and complete documentation of services reconciliation of daily charges, accurate and complete charge entry, and electronic and/or manual submission of claims in compliance with Payor specific procedures.

DUTIES AND RESPONSIBILITES:

  • Ensure medical data is secure, accessible and accurate for billing and reimbursement for all services
  • Develop Standard Operating Procedures to ensure controls are in place to comply with regulations and best practices in managing cash and receipts
  • Overseeing collections processing, going over insurance pre-authorizations and verifications and tracking payment and payment plans
  • Maintaining a comprehensive knowledge of contemporary health record and coding practices
  • Works closely with the account receivable manager, center managers, team leaders, and corporate medical director to ensure all processes are streamlined to minimize disruption in patient care while maximizing reimbursement

KNOWLEDGE, SKILLS, AND ABILITIES:

  • Exceptional Customer Experience – Understands and anticipates customer needs, takes action to meet customer’s needs. Strives to exceed customer expectations
  • Proactive- Keep others informed. Ask for help when needed, brings service challenges to supervisor
  • Drive for Results – Strives for improving the delivery of services with a commitment to continuous improvement
  • Focus on Efficiency – Utilizes technology, innovation, and process improvements to continuously improve efficiency and effectiveness
  • Teamwork- Participates as a team member and establishes strong working relationships with teammates and across the organization
  • Celebrates Change- Receptive to new ideas and responds to changes with flexibility and optimism.
  • Continues Learning and Improvement- Acknowledges own strengths and development needs and works to strengthen capabilities

EDUCATION:

  • Bachelors degree or equivalent with 2 years of experience

TYPICAL PHYSICAL DEMANDS:

  • Sitting, Standing, Bending, Reaching, Stooping, Walking and Lifting
  • Ability to see, hear, and speak with sufficient capability to perform assigned tasks
  • Driving independently to other facilities

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be construed as an exhaustive list of all duties to be performed.