Claims Reconciliation Specialist
About The Position
The Claims Reconciliation Specialist handles comprehensive billing procedures and verification before coding for anesthesia services. The role ensures accurate documentation collection, provider verification, and compliance with medical direction requirements to support revenue recovery. This is a full-time position based at the corporate office in Addison, Texas, with on-site work during regular business hours. The role reports to the Intake/Scrubbing Lead. Responsibilities include collecting complete anesthesia records; confirming provider and case details; reviewing anesthesia times, breaks, and hand-offs; checking medical-direction documentation and coding modifiers; verifying supporting documentation for additional procedure codes; confirming insurance eligibility and authorizations; reviewing charge tickets; and managing complete case batches for the data-entry team.
Requirements
- High school diploma or equivalent.
- At least 2 years of experience in medical billing, particularly anesthesia billing.
- Knowledge of CPT, ICD-10, and anesthesia-specific coding, including ASA base units, time units, and modifiers.
- Understanding of medical direction versus medical supervision billing requirements.
- Familiarity with CMS guidelines for concurrent care limitations.
- Proficiency in practice management software and electronic health records.
- Strong attention to detail and analytical skills.
- Excellent communication and problem-solving abilities.
Nice To Haves
- Associate degree in healthcare administration preferred.
Responsibilities
- Collect complete anesthesia records, including pre-anesthesia evaluations, intraoperative records, PACU documentation, and addendums.
- Confirm applicable providers are identified with supervising and rendering provider details.
- Validate dates of service and facility information, and cross-check surgeon details against anesthesia records.
- Verify anesthesia start and stop times, document breaks and hand-offs, and ensure consistency across cases.
- Ensure documentation includes the seven required elements for medical direction: pre-anesthesia evaluation, presence at induction, monitoring, availability, emergence, post-anesthesia care, and a 4:1 supervision ratio.
- Confirm correct ASA status assignments and anesthesia modifiers.
- Verify documentation supporting additional procedure codes for pain blocks, line placement, and ultrasound guidance.
- Confirm patient eligibility and obtain required authorizations.
- Ensure anesthesia records align with internal charge tickets.
- Verify case counts and upload complete batches for the data-entry team.
Benefits
- Competitive compensation
- Health insurance
- Dental insurance
- Vision insurance
- 401(k) with 3% non-discretionary company contributions
- Professional development opportunities
- Fun collaborative work environment
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
