Medical Billing Specialist
About The Position
The Medical Billing Specialist is responsible for the timely follow-up of claims billed and the resolution of accounts. Oversees the account receivables and maintains detailed/accurate account documentation. Follow up on open claims thoroughly, accurately, promptly, and with all supporting documentation responsible for maintaining and updating billing guidelines, fee schedules, contract rates, etc. Review, document and resolve all incoming correspondence and payor calls; assist as needed on aging reports, reports all payor issues and/or denial trends to Lead/Supervisor and may appeal and/or rebill underpaid claims and assist with payments as needed. Essential Functions Review billing claim forms to ensure fields are accurately populated and aligned. Identify and return incomplete claim information and /or supporting documentation to meet payor requirements Initiate contact and respond to inquiries from various external sources Comply with all government and third-party payers, regulatory mandated requirements for billing collects and PHI Answer questions and assist AR regarding billing issues as needed Ability to maintain confidentiality of all information under HIPPA guidelines Meet departmental productivity and quality standards in time frame given upon completion of training
Requirements
- Medical Billing and Coding
- Reimbursement
- Billing Operations
- Medical Billing Software
- Insurance claims processing
- ICD Coding
- Patient Care
- Medicare Billing
- Demonstrated skill to be self-directed, coupled with exemplary time management skills and the ability to simultaneously manage multiple tasks
- Ability to execute processes efficiently and maintain the highest level of quality
- Demonstrates ability to identify and communicate issues
- Computer literacy skills, including Google and Excel spreadsheets and Microsoft Office products
- Enhanced communication and customer service skills
Nice To Haves
- Experience and working knowledge of 1500 claim forms
- Experience with billing editor systems
- Understanding of the entire revenue cycle process
- Knowledge of Revenue and ICD coding language
- 1-2 years of back-end revenue cycle experience in a facility and hospital setting
- Knowledge of Medicaid and Medicare billing regulations
Responsibilities
- Responsible for the timely follow-up of claims billed and the resolution of accounts
- Oversees the account receivables and maintains detailed/accurate account documentation
- Follow up on open claims thoroughly, accurately, promptly, and with all supporting documentation responsible for maintaining and updating billing guidelines, fee schedules, contract rates, etc.
- Review, document and resolve all incoming correspondence and payor calls
- Assist as needed on aging reports
- Reports all payor issues and/or denial trends to Lead/Supervisor and may appeal and/or rebill underpaid claims and assist with payments as needed
- Review billing claim forms to ensure fields are accurately populated and aligned
- Identify and return incomplete claim information and /or supporting documentation to meet payor requirements
- Initiate contact and respond to inquiries from various external sources
- Comply with all government and third-party payers, regulatory mandated requirements for billing collects and PHI
- Answer questions and assist AR regarding billing issues as needed
- Ability to maintain confidentiality of all information under HIPPA guidelines
- Meet departmental productivity and quality standards in time frame given upon completion of training
Benefits
- We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
11-50 employees
