Job Description

EMPLOYER (Princeton Dermatology Associates): Princeton Dermatology Associates (PDA) is a leading dermatology/dermatological surgery practice with several offices in the State of New Jersey. We are looking to hire two (2) full time, experienced, Medical Billing Specialist to join our team. The successful candidate will be personable, intelligent, and a dynamic team player, with excellent customer service and phone handling skills, and at least three years of work experience in a similar practice (preferably dermatology). Please note this is NOT a remote position; the work is onsite in our Princeton Office. PDA offers a very competitive compensation package based on qualifications and experience, along with a full array of benefits, that include comprehensive medical, dental and vision insurance, generous paid time off (PTO) pay, 401 K Plan with generous employer matching (Safe Harbor Plan), flexible spending plan, etc. PDA is committed to providing complete medical and cosmetic skin care for our patients. Our single specialty dermatology practice provides medical care treating all types of skin conditions and problems. We provide skin cancer detection and treatment. We also offer highly specialized surgical services including Mohs Micro graphic Surgery, laser treatments, cosmetic facial treatments, and sclerotherapy. At PDA we strongly believe that people are our greatest asset, and we strive to challenge them professionally and to provide opportunities for growth within the organization. JOB SUMMARY: Responsible for all facets of medical billing and accounts receivable management including charge entry, payment posting, customer service and follow-up with an emphasis on maximizing patient satisfaction and profitability. Responsible for reviewing the patient demographic information in the practice management system to ensure accuracy and to provide feedback to the manager. Responsible for reviewing the physician’s coding to ensure accuracy, timely payments, and to maximize revenue. Responsible for submitting insurance claims. SPECIAL CHARACTERISTICS: This position requires a comprehensive understanding of accounts receivable management in a healthcare setting. This position requires strong working knowledge of managed care plans, insurance carriers, referrals and pre-certification procedures. Also required is a strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines. Strong customer service, organizational and communication skills are essential to this position. In addition, strict adherence to write-off policies, refund policies and other accounts receivable policies is required. This position requires an ability to prioritize multiple tasks simultaneously in an occasionally stressful environment. Also required are general computer skills, typing skills and a working knowledge of Medicare Compliance, OSHA and HIPAA. EDUCATION: High school diploma or GED is required. Certification as a Professional Coder highly desired. EXPERIENCE: Requires a minimum of 3 years of accounts receivable experience preferably in Dermatology. Knowledge of CPT and ICD-10 coding. CPC coding certification a plus. ESSENTIAL FUNCTIONS : Review charges related to the assigned physician’s professional services into the practice management system including office and hospital charges in accordance with practice protocol with an emphasis on accuracy to ensure timely reimbursement and maximum patient satisfaction. Post all payments for services into the practice management system including co-payments, insurance payments, and patient payments with an emphasis on accuracy to ensure maximum patient satisfaction and profitability. All payment batches must be balanced. Maintain daily posting log and report to manager. File payment batches and explanation of benefits by batch date for quick reference. Review the physician’s coding at charge entry to ensure compliance with Medicare guidelines and to ensure accurate and timely reimbursement. Provide customer service both on the telephone and in the office for all patients and authorized representatives regarding patient accounts Verify all demographic and insurance information in patient registration of the practice management system at the time of charge entry to ensure accuracy, provide feedback to manager. Follow-up on all outstanding insurance claims with an emphasis on maximizing patient satisfaction and practice profitability. Follow-up on all outstanding patient accounts with an emphasis on maximizing patient satisfaction and practice profitability using the A/R aged reports. Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians, managers and subordinates. Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction. Submit primary and secondary insurance claims to ensure timely reimbursement. Attendance at relevant seminars to remain abreast of current issues regarding accounts receivable, Medicare Compliance and HIPAA. Recommend accounts for outside collection when internal collection fails. Process refunds to insurance companies and patients. Reconcile the incoming deposits to ensure timely payment posting. Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates. Monitor the supply and quality of forms, envelopes and supplies as required to perform job functions. Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry. Maintain information regarding coding, insurance carriers, managed care networks and credentialing in an organized easy to reference format. Maintain an organized, efficient and professional work environment. Adhere to all practice policies related to OSHA, HIPAA and Medicare Compliance. Other duties as assigned. SKILLS: The jobholder must demonstrate current competencies applicable to the job position. Requires excellent written and verbal communication skills and strong customer service skills. Requires strong basic mathematical skills. Requires a minimum typing speed of forty (40) words per minute and ten-key by touch. Requires an extensive working knowledge of managed care networks and insurance carriers. Requires an extensive working knowledge of accounts receivable functions including CPT and ICD-10 coding. Requires proficiency in general office automation including operation of fax machines, copy machines, adding machines, postage machines, and multi-line phone systems. Requires proficiency in working with a PC, the Internet, and MS Office. Requires a good understanding of the current Medicare Compliance, OSHA, and HIPAA regulations. Requires a high degree of organization. ABILITIES: Ability to establish/maintain cooperative working relationships with staff and providers. Ability to communicate effectively and in a professional manner. Ability to prioritize and multi-task.

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