Tower Surgical Partners (TSP) is a management company specializing in the unique needs of minimally invasive surgery centers and physician practices. TSP partners with physicians to expand existing and develop future surgical centers for long-term growth. TSP is seeking the services of an experienced Sr. Medical Billing Specialist to support our surgery center in Secaucus, NJ as well as our medical practices in NJ and NY.
TSP is a comprehensive Ambulatory Surgical Center (ASC) management company with experts in site development/acquisition, legal, finance, state accreditation, policies, and operations. TSP works closely with its clinical partners to provide access for patients to the highest quality GYN surgical services available. They have developed new procedural technology including DualPortGYN and LAAM procedures allowing major GYN surgical procedures to be performed in an outpatient ASC setting.
The Medical Billing Specialist will manage payment posting, charge entry for surgical procedures, follow up on unpaid claims utilizing monthly aging reports, file appeals, and work with patients regarding insurance explanations of benefits and insurance verifications, specifically with out of network benefits.
- Works closely with the Revenue Cycle team to ensure all claims are submitted with a goal of zero errors
- Verifies completeness and accuracy of all claims prior to submission
- Accurately posts all insurance payments by line item
- Responds to inquiries by insurance companies, patients, and providers
- Provides financial counseling and educates and assists patients who present as “out of network” or “self-pay” to ensure understanding of patient financial responsibility.
- Fulfills medical records/audit requests
- Completes additional information requests as requested by insurance companies
- Provides timely follow-up on insurance claim denials, exceptions, or exclusions
- Utilizes monthly aging accounts receivable reports to follow up on unpaid claims
- Verify and understand insurance information (eligibility and benefits)
- Answer patient inquiries on benefits coverage, account status, and charges
- Prepare patient statements and distribute on determined schedule
- Follow necessary HIPAA regulations and policies on confidentiality
- Bachelor’s Degree (preferred); HSG required
- 5 or more years of third party payer billing experience (professional and facility) in the healthcare environment
- Out of network billing experience is required
- Experience providing patient financial counseling on benefits coverage, account status, and patient financial responsibility
- Experience with EMR, electronic billing system, and multiple insurance verification portals required
- Excellent customer service, teamwork, and communication skills