Medical Billing Specialist

TSAOG Orthopaedics & SpineSan Antonio, TX
just now

About The Position

Medical billing specialists are responsible for managing the flow of money into and out of an organization

Requirements

  • Must have a High School Diploma or equivalent.
  • 2-4 years of experience in the field or in a related area. Relies on experience and judgment to plan and accomplish goals. Familiar with standard concepts, practices, and procedures within realm of responsibility.
  • Ability to read and interpret insurance explanation of benefits and managed care contracts.
  • Must communicate effectively, both verbally and in writing, with internal and external clients
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines

Responsibilities

  • Speaking with patients to collect payments for services rendered, negotiating payment plans with them, and following up on delinquent accounts
  • Develop and maintain a comprehensive understanding of the revenue cycle process.
  • Timely follow-up and resolution on all A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.
  • Manage daily work queue to prioritize high dollar claim balances.
  • Review and work incoming insurance and patient correspondence including refund request.
  • Working with insurance companies to determine coverage for medical procedures or treatments
  • Consulting with hospital administrators regarding changes in regulations that may affect billing practices
  • Reviewing claims to ensure that they are correctly coded according to industry standards
  • Communicating with physicians’ offices to obtain clinical documentation needed to support claims
  • Reviewing patient records to identify insurance coverage or possible treatment complications that could affect claims processing
  • Reporting claims status to clients on a regular basis to ensure accurate communication between departments within a healthcare organization
  • Requires predictable and consistent attendance
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