About the Role:
The Billing Specialist / Medical Record plays a critical role in ensuring the accuracy and efficiency of medical billing and record management within a healthcare setting. This position is responsible for processing patient billing information, verifying insurance details, and maintaining comprehensive and compliant medical records. The role requires close collaboration with healthcare providers, insurance companies, and patients to resolve billing discrepancies and facilitate timely payments. By managing both billing and medical records, the specialist helps optimize revenue cycle management and supports the delivery of high-quality patient care. Ultimately, this position ensures that financial and medical documentation processes adhere to regulatory standards and contribute to the overall operational success of the healthcare organization.
Qualifications:
- High school diploma or GED required.
- Familiarity with medical billing software and electronic medical records software.
- Minimum of one year of medical records or healthcare office experience is a plus.
- A Minimum of 2 years of experience in medical billing or similar role.
- Strong understanding of insurance processes, billing codes (CPT, ICD-10), and healthcare regulations such as HIPAA.
- Excellent attention to detail and organizational skills.
- Strong communication skills for effective interaction with patients and insurance representatives.
- Ability to prioritize multiple tasks in a fast-paced environment.
Responsibilities:
- Review and process patient billing information accurately and in a timely manner.
- Communicate with healthcare providers, insurance companies, and patients to resolve billing issues and discrepancies.
- Prepare and submit claims to insurance companies and follow up on unpaid or denied claims.
- Reviews patient accounts to ensure accuracy and completeness of claims billing for maximum reimbursement.
- Stay current with changes in healthcare billing codes, insurance policies, and regulatory requirements.
- Respond to medical records request from physicians, hospitals, insurance companies, attorneys and patients in a timely manner.
- Maintain confidentiality of all patient information.
- Performs other related duties as assigned by management.
Skills:
The Billing Specialist / Medical Record uses their expertise in medical billing codes and insurance policies daily to ensure accurate claim submissions and minimize denials. Attention to detail is critical when reviewing patient records and billing information to maintain compliance with healthcare regulations and protect patient privacy. Communication skills are essential for resolving discrepancies and collaborating with healthcare providers and insurance companies. Proficiency with electronic health record systems and billing software enables efficient data entry, record keeping, and reporting. Additionally, analytical skills help identify trends in billing and collections, supporting continuous process improvements within the healthcare organization.