Medical Billing/Business Office Representative

JOB TITLE: Medical Billing/Business Office Rep

JOB SUMMARY/RESPONSIBILITIES:

The Business Office Representative supports the financial and operational functions of a small physician's office by coordinating third-party billing and processing payments for the business office.

This role focuses on improving efficiency, ensuring accurate billing and collections, and supporting day-to-day business office operations. The ideal candidate is analytical, detail-oriented, and comfortable working in a hands-on, fast-paced practice environment.

Primary Responsibilities:

• Performs duties related to the insurance billing function of the business office
• Completes accurate and timely insurance verification.
• Processes patient, insurance, and other payments as directed
• Prepares weekly and monthly reports on third-party billings
• Prepares weekly and monthly reports account pending diagnoses and late charges.
• Performs insurance follow-up procedures.
• Performs other specified clerical or administrative duties as assigned
• Completes the business office work activities assigned daily in a timely fashion
• May maintain office equipment, including cleaning, maintenance, and repairs as needed
• Answers phones, sorts and distributes mail, and prepares documents
• Maintains office files; implements an efficient system for other staff
• Ensures services scheduled by outside providers have approved authorization as required by payer and procedure prior to service
• Communicates with patients, insurers, and other appropriate parties pertaining to insurance verification and authorization
• Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program
• Refers underinsured/uninsured patients and/or point-of-service pre-payment required services to the Pre-Service Patient Financial Responsibility and/or Financial Assistance team(s) to determine if the patient is eligible for assistance and obtain payment prior to services being received, when applicable, to help manage the organization's bad debt
• Creates a positive patient experience by being polite, compassionate, and professional
• Provides cross-coverage and training, when needed, for other team members
• Maintains productivity and quality performance expectations
• Regular attendance is required to carry out the essential functions of the position
• Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge, and abilities to perform, within scope, role-specific functions
• Performs other duties, tasks, and responsibilities as assigned

EDUCATION/QUALIFICATION REQUIREMENTS: 

• High school diploma or equivalent required; Associate's degree in office administration or related field preferred

• At least three years of administrative and clerical experience in a healthcare office setting (medical billing) required, providing excellent customer service. Understanding of physician office workflows and revenue cycle processes
• Two or more years of Accounts Receivable experience required, with orthopedic and pain management billing experience highly desirable
• Well-developed skills in medical insurance coordination, eligibility verification, and benefits administration

PHYSICAL/MENTAL DEMANDS:

• Able to read, write and communicate in English
• Have cognitive skills for math, decision making and excellent communication skills
• Potential for contact with chemicals, blood borne pathogens, and exposure to infectious disease.

• Office-based position in a multi-specialty physician
• Frequent interaction with patients, staff, and providers
• Primarily sedentary work with computer-based tasks

ENVIRONMENTAL/WORKING CONDITIONS: The work environmental characteristics described above are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Work Location- In Person, Mayfair Clinic 3077 N Mayfair Rd, Wauwatosa WI

Hours- FT, Monday through Friday.