Medical Billing Specialist
Monday-Friday 8am-5pm | $18-$23/hourDOE | Temp to Perm
Summary:
Responsible for insurance claim submission, follow up, and resolution for commercial, Medicare, Medicaid, and patient accounts. Responsible for all patient account collection efforts, including, but not limited to, generating patient statements, making payment arrangements, collecting on accounts, monitoring and pursuing delinquent accounts. Ensures billing practices that are prompt, ethical, and compliant with organizational, payer, and governmental regulations and guidelines.
Duties and Responsibilities:
โขSubmit claims and follow up with insurance payer on unpaid, rejected, or denied claims.
โขCorrect and resubmit claims as necessary.
โขCollect and enter claim information as necessary.
โขEnsure claim information is complete and accurate.
โขSubmits insurance claims to payer electronically or via paper.
โขPrepares and submits appeal letters to payer when not in agreement with claim denial.
โขPrepare and submit secondary and tertiary claims as needed.
โขAssess aged accounts to establish adjustment recommendations.
โขPost insurance and patient payments using medical billing software.
โขAssist internal staff in answering questions pertaining to billing.
โขCreate and monitor aging reports to ensure timely follow up and resolution.
โขAbility to analyze claims in order to identify trends.
โขPrepare patient refund requests for approval by Revenue Cycle Director.
โขEstablish and maintain payment plans for patient accounts.
โขCollect on delinquent patient accounts through phone and mail correspondence.
โขAssist internal staff in answering questions pertaining to billing.
โขAssist Revenue Cycle Director to resolve claim/billing issues as needed.
โขMaintain up-to-date procedure manual.
โขWorks with Information Technology (IT) and Revenue Cycle Director to resolve electronic health record (EHR) technical issues relatedto billing.
โขMaintains confidentiality of information at all times. Process pre-authorization requests for specialty services as needed.
โขAdheres to professional standards, organizational policies and procedures, federal, state, and local requirements; and Joint Commission standards.
โขMay perform other duties as assigned.
Qualifications and Skills:
โขTwo (2) to five (5) years of previous medical billing and/or outpatient claims experience preferred.
โขCertificate in Medical Billing/Coding and/or Associateโs Degree in Health Information Management, Business, or related field preferred.
โขCCA, CCS, CCS-P, RHIT, RHIA, CPC, COC, and/or CPB credentials preferred.
โขProficiency in ICD-10 and CPT medical billing codes.
โขBilingual English/Spanish is a plus, but not required
โขExtensive knowledge of insurance claim submission and reimbursement processes.
โขExtensive knowledge of Medicare and Medicaid billing protocol.
โขExcellent skills in time management, cognitive reasoning, workflow solutions, etc.
โขExcellent skills in Math, English usage, grammar, punctuation and style.
โขExcellent written and verbal communication skills.
โขHighly organized and detailed oriented.
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