Medical Billing Specialist

Orthocincy•Edgewood, KY

22h•Onsite

About The Position

Promotes the Companies mission to provide patients with premier orthopedic care while focusing on their individual needs. Responsible for ensuring timely claim submission, follow-up with no response from payers, payer rejections, correspondence, and appealing denial.

Requirements

High School Diploma or equivalent.
Customer service oriented with a team environment focus.
Must be able to remain focused and attentive without distractions (i.e. personal devices).
Must be able to use appropriate body mechanics techniques when making necessary patient transfers and helping patients with walking, etc.

Nice To Haves

Associate’s Degree in Coding/Billing or minimum of two years medical billing experience.
Collections or medical billing experience with an understanding of HCPCS, ICD-10 and medical terminology.
Knowledge and application of the Companies Mission, Vision and Values.
Medical billing terminology required.
CPT and ICD-10 coding knowledge preferred.
Knowledge of medical billing/collection practices.
Knowledge of medical terminology and anatomy.
Knowledge of insurance filing and payment posting techniques.
Knowledge of basic medical coding and third-party operating procedures and practices.
Knowledge of electronic health records and practice management systems.
Knowledge of current professional billing and reimbursement procedures preferred.
Skilled in attention to detail.
Skilled in organizing.
Skilled in grammar, spelling, and punctuation.
Skilled in communicating effectively with providers, staff, patients and vendors.
Strong communication skills in a professional manner during stressful and sensitive situations with patients of all ages.
Ability to problem-solve and the ability to interpret and make decisions based on established guidelines.
Ability to work on a team while maintaining positive and professional relationships.
Ability to multitask and handle stressful or difficult situations with professionalism.
Ability to analyze situations and respond in a calm and professional manner.

Responsibilities

Ensuring timely claim submission, follow-up with no response from payers, payer rejections, correspondence, and appealing denial.
Communicating with patients, providers, clinical staff, payers, and outside agencies through telephone, electronic, and written correspondence in a friendly and professional manner.
Managing multiple work queues for an assigned portion of the Accounts Receivable (A/R) daily on registration, claim edits, aging, and denials.
Following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments.
Assisting with verification of benefits information to determine coordination of benefits via phone, email, or online portal.
Analyzing EOB’s and constructing appropriate, timely responses to insurance carriers based on claim adjudication.
Collaborating with manager, coordinator, and director to report denial trends to ensure proper claim resolution.
Handling billing calls and answering telephone calls as needed.
Reviewing credit balance accounts.
Ensuring compliance with all guidelines set by government programs, and the Companies policies, such as federal regulations, HIPPA, and the No Surprises Act.
Performing additional tasks that may be necessary or in the best interest of the practice.