Hospital Billing Specialist-Medical Coder
About The Position
The Hospital Billing Specialist plays a critical role in ensuring accurate and timely processing of patient billing and insurance claims within a healthcare setting. This position is responsible for managing the entire billing cycle, from verifying patient information and insurance coverage to submitting claims and resolving discrepancies. The specialist collaborates closely with healthcare providers, insurance companies, and patients to facilitate smooth financial transactions and optimize reimbursement. By maintaining compliance with healthcare regulations and billing standards, the role helps safeguard the hospital’s revenue stream and supports overall financial health. Ultimately, the Hospital Billing Specialist contributes to a positive patient experience by addressing billing inquiries and ensuring transparency in charges.
Requirements
- High school diploma or equivalent required
- Proficiency with medical billing software and electronic health record (EHR) systems.
- Strong understanding of medical terminology, insurance processes, and billing codes (CPT, ICD-10).
- Excellent communication and organizational skills.
Nice To Haves
- Associate degree in healthcare administration or related field preferred.
- Certification as a Certified Coding Specialist (CPC or CPC-A).
- Experience with Medicare, Medicaid, and private insurance billing procedures.
- Familiarity with HIPAA regulations and patient privacy standards.
- Advanced knowledge of healthcare reimbursement methodologies and compliance requirements.
- Minimum of 2 years experience in medical billing, preferably in a hospital or clinical setting.
Responsibilities
- Review and verify patient demographic and insurance information for accuracy before billing.
- Prepare and submit insurance claims electronically and via paper to ensure timely reimbursement.
- Collaborate with clinical and administrative staff to clarify coding and billing discrepancies.
- Stay updated on changes in insurance policies, billing codes, and healthcare regulations.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
101-250 employees
