Senior Medical Billing Specialist
About The Position
The Billing Specialist is responsible for supporting the full revenue cycle through accurate coding review, payer rule verification, authorization submission, patient estimate generation, account resolution, and customer service support. This role works closely with clinical teams, patients, and insurance payers to ensure timely and compliant billing processes. All Billing Specialists will participate in team workshops and project days to support continuous improvement initiatives. The Level III Billing Specialist is an advanced-level role responsible for high-complexity billing functions, in-depth A/R resolution, and subject-matter expertise in coding and payer rules. This role serves as a resource to the Billing Department, supporting escalations, workflow improvements, and training initiatives.
Requirements
- Minimum 2 years of experience in medical billing, A/R management, or revenue cycle operations.
- Strong knowledge of coding validation, payer rules, authorizations, and denial management.
- Proven ability to resolve complex billing issues independently.
- Excellent communication, analytical, and training abilities.
- Effective time management with exceptional attention to detail
- Commitment to the mission and values of Vanguard Skin Specialists
Responsibilities
- Independently review and process coding corrections, payer rules, and documentation requirements identified by the RCx Coding Application.
- Manually code OR Face Sheets for our Plastic Surgeons and enter charges into the RCx Coding Application.
- Monitor Charge Reconciliation and coordinate with Providers and Clinical teams to ensure timely submission
- Submit prior authorizations across a mix of payers, ensuring timely follow up and documentation.
- Provide comprehensive and timely surgery estimates to patients; proactively clarify benefit discrepancies when needed.
- Manage assigned A/R worklists, including claim corrections, resubmissions, and denial follow-up.
- Research insurance overpayments, initiate refund workflows, and provide supporting documentation.
- Serve as an expert resource for the Billing Phone Line, Billing Inbox, and Billing Help Desk
- Participate and contribute to departmental workshops and project days.
- Mentor team members, assist with training and onboarding of new staff.
- Assist leadership with reporting, trend identification, and process enhancement initiatives.
Benefits
- The practice covers a portion of the premium for medical benefits and offers vision, dental, and 401K.
- Paid Time Off
- Graduate School Stipend
- bereavement pay
- Paid Maternity & Bonding Leave
- Employee Discounts on products and aesthetic services.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
101-250 employees
