|Specialties:||Pediatrics, Primary Care
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
|Location:|| Warrenton 20186, VA, US
• Plans, directs and supervises billing staff to ensure timely, accurate and complete processing of billing services.
• Plans and directs quarterly financial meetings with practice owners and administrator.
• Runs month end financial reports and provides financial information to administrator and accountant.
• Performs bi-annual chart audits on all providers.
• Manages the collection process by working with the collection agency, preparing accounts for collection, monitoring collection efforts for payments, contacting patients by phone and resubmitting claims to third party payers.
• Manages medical records and HEDIS charts.
• Monitors reimbursement patterns and implements changes in reimbursement procedures.
• Keeps current with CPT and ICD coding updates by adding and deleting codes as well as effectively communicating changes to all providers and billing staff.
• Maintains reimbursement profiles from third party payers and compares with office fees.
• Maintains File Maintenance and Patient Portal with regards to NextGen EPM/EHR database.
• Updates staff on participating insurance company policy changes.
• Communicates with insurance payer representatives regarding payer reimbursement and contract.
• Resolves patient billing complaints.
• Answers billing questions from patients, staff and insurance companies.
• Leads efforts for various insurance program incentives (ie Meaningful Use, MACRA, PQIP)
• Creates a schedule for the Billing Department staff and processes requests for days off.
• Fills in for staff as needed.
• Participates in educational activities.
• Conducts self in accordance with the Practice’s employee manual.
• Maintains strictest confidentiality; adheres to HIPAA guidance/regulations.
• Other duties as assigned by Practice Administrator.