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Medical Billing Specialist (Remote)

The Medical Billing Specialist is responsible for performing functions necessary for accurate and efficient manual and electronic claims processing for all patient account bills. Ideal candidates to be considered for this position will reside in Pennsylvania, Ohio, or West Virginia.

Job Responsibilities:

• Completes electronic and manual billing for all patient accounts in a timely manner.

• Performs electronic billing via electronic health record and clearinghouses.

• Demonstrates knowledge of HCFA 1500 billing criteria.

• Demonstrates comprehensive ability and knowledge of electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions.

• Demonstrates knowledge of CPT-4, ICD-10, usage of modifiers, and HCPCs coding according to all federal and state regulatory guidelines.

• Demonstrates a thorough knowledge and understanding of benefits and/or coverage as indicated by third party payer requirements.

• Demonstrates in depth knowledge of insurance authorizations with relation to medical billing.

• Performs and regularly updates insurance and physician credentialing to ensure timely processing and payment of claims.

• Communicate with work partners to inform of instructions necessary to complete tasks in a timely fashion.

• Promptly corrects and processes rejected, invalid or denied claims.

• Effectively manages accounts receivable and collections for all assigned clients.

Additional Responsibilities:

• Supplies statistical information to the Practice Manager as directed

• Keeps current on all federal, state, and payer specific billing and compliance guidelines

• Informs the Practice Manager of issues that may relate to the timely processing of the entire patient claim operations

• Completes the necessary processes for variance reports relating to un-billed claims, to maintain billing operations in a timely manner. Typically, a timely manner would be 24 hours

• Documents all information and conversation into the electronic billing record regarding patient account activity

• Consistently utilizes available work time to complete all required tasks within established time frames and schedules

• Conducts professional interaction with all co-workers, other departments, and outside agencies

• Performs other duties as assigned

Minimum Requirements:

• High school diploma or equivalent required

• Medical Billing: 3 years

• Two years claim processing in a physician setting required

• Knowledge of the Medent, MicroMD, eClinical Works, Epic, NextGen and Change Healthcare Clearinghouse systems

Preferred Minimum Requirements:

• Associate degree in healthcare related field or medical office training preferred