Medical Billing Specialist

Prevounce Health•Indianapolis, IN

About The Position

Prevounce Health is seeking a detail-oriented and organized Medical Billing Specialist to support its growing healthcare operations. The role is responsible for accurately processing medical charges, reviewing billing information, submitting claims, and assisting with billing-related issues to support timely and accurate reimbursement. The ideal candidate has medical billing experience, familiarity with Medicare billing guidelines, and the ability to manage a high volume of claims while maintaining accuracy. Experience with NextGen and billing for Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) programs is highly preferred. The ideal candidate is dependable and detail-oriented, understands the importance of accurate claims processing and timely reimbursement, and can work in a fast-paced environment. Strong problem-solving skills and the ability to manage billing responsibilities efficiently while maintaining accuracy and compliance are important.

Requirements

At least 1 year of experience in medical billing, charge entry, claims processing, or a related healthcare revenue cycle role.
Working knowledge of medical billing procedures, insurance claims, and reimbursement processes.
Familiarity with CPT, ICD-10, and HCPCS coding.
Understanding of Medicare billing guidelines and requirements.
Experience working with electronic health records (EHR) or practice management systems.
Strong attention to detail and organizational skills, with the ability to manage high-volume workloads.
Ability to identify and resolve billing errors independently.
Strong written and verbal communication skills.

Nice To Haves

Experience using NextGen for medical billing or charge entry.
Experience billing Medicare RPM and CCM services.
Familiarity with medical claim edits, denials, and corrections.
Experience in a high-volume healthcare billing environment.
Medical billing or coding certification, such as CPC, CPC-A, CCS, or RHIT.

Responsibilities

Accurately enter and process medical charges, ensuring required patient, provider, and service information is complete.
Review, prepare, and submit medical claims in accordance with payer requirements and established billing procedures.
Verify CPT, ICD-10, and HCPCS codes for appropriate billing and documentation.
Apply Medicare billing guidelines, including requirements for RPM and CCM services.
Identify and resolve billing discrepancies, claim edits, and submission errors to minimize delays and denials.
Review patient insurance information and eligibility to support accurate claims processing.
Use NextGen and other billing platforms to enter charges, review claims, and maintain accurate billing records.
Meet established daily billing and charge-entry expectations while maintaining high accuracy standards.
Communicate with internal departments to resolve missing documentation, coding discrepancies, and other billing-related concerns.
Maintain compliance with HIPAA, Medicare regulations, payer guidelines, and company policies.