Lake Erie College of Osteopathic Medicine - Billing Specialist - Erie, Pennsylvania

JOB SUMMARY: The Billing Specialist is responsible for collecting, posting, and managing account payments, as well as submitting claims and following up with insurance companies on a daily basis.

CHARACTERISTIC JOB TASKS AND RESPONSIBILITIES:

Prepares and submits clean claims to various insurance companies either electronically or by paper;
Submits, reviews, and updates dental insurance pre-authorizations. Reviews outcome with students and/or patients as needed;
Performs daily insurance eligibility for insurance patients for all LECOM Dental Clinics;
Works directly with 3rd party insurance biller to ensure successful claim submission and payment allocation;
Answers questions from patients, faculty, staff, and insurance companies;
Identifies and resolves patient billing complaints;
Prepares, reviews, and sends patient statements;
Evaluates patient’s financial status at the direction of the Director of Practice Finance and/or his/her designee;
Follows and reports status of delinquent accounts;
Reviews accounts for possible assignment and makes recommendations to the Director of Finance, PCC –Supervisor, and/or his/her designee;
Prepares various information for the collection agency on an as-needed basis;
Performs daily backups on office computer system and associated office programs (i.e. AxiUm …etc.);
Performs various collection actions including, but not limited to, contacting patients by phone, correcting and resubmitting claims…etc.;
Processes payments from insurance companies and prepares a daily deposit;
Participates in educational activities and attends monthly staff meetings as designated;
Conducts self in accordance with LECOM’s employee handbook;
Maintains strictest confidentiality; adheres to all HIPAA / FERPA guidelines/regulations;
Must work in conjunction with the faculty & students to maintain patient flow;
Protects money, checks, credit cards, and insurance information;
Contributes directly to the Mission of LECOM embodying the essence of Osteopathic Principles and Practices by assisting with Institutional fundraising and participating in the LECOM Scholarship Auction;
Participates in scholarly activity to enrich and broaden the student learning experience;
Commits to being a representative of LECOM by being actively involved in the community, including, but not limited to, serving on Boards, participating in community fundraisers, and overall outreach;
Accepts other duties needed/assigned for the practice needs.

EEO/AA/M/F/Vets/Disabled

KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS: Must possess required knowledge and be able to explain and demonstrate, with or without reasonable accommodations, that the essential functions of the job can be performed.

Knowledge of dental billing/collection practices (i.e. dental Insurance and reimbursement), specifically with state Medicaid Dental Plans;
Knowledge of business office procedures;
Knowledge of basic dental coding and third-party operating procedures and practices;
Ability to operate a multi-line telephone system;
Proficiency in answering a telephone in a pleasant, polite, and helpful manner;
Ability to read, understand, and follow oral and written instructions;
Compliance with State and Federal Regulations and Safety Protocols at the practice level;
Knowledge of patient’s privacy (HIPAA) and student privacy (FERPA);
Follow proper OSHA and safety guidelines;
Strong communications skills are essential as well as computer literacy (MS Office Suite - Word, PowerPoint, Excel, etc.) and accurate data entry skills;
Maintaining an established work schedule and one’s work area in an orderly manner;
Effectively using interpersonal and communication skills including tact and diplomacy;
Effectively using organizational and planning skills, including attention to detail and follow-through;
Assessing and prioritizing multiple tasks, projects, and demands;
Ability to establish and maintain effective working relationships with patients, employees, and the general public;
The ability to work cooperatively and collegially with others, consistent with a workplace of dignity and respect and EEO rules and regulations;
The ability to report to work as scheduled, ready to devote full attention and energy to the important work of LECOM;
The ability to accept work directives from managers and supervisors in a respectful and cooperative manner;
Be able to be flexible to accept other duties needed/assigned for the practice needs.

MINIMUM QUALIFICATIONS:

Education and experience equivalent to: High school diploma or GED required; AS or BS degree optional. Work experience in a similar job responsibility preferred. Computer and online interactive knowledge a must.

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Lake Erie College of Osteopathic Medicine

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Billing Specialist