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

• Work Location- In Person, Mayfair Clinic 3077 N Mayfair Rd, Wauwatosa WI
• Hours- FT, Monday through Friday.