Medical Billing Specialist
3 weeks ago
The Medical Billing Specialist is responsible for accurately coding fertility diagnostic ,treatment services and surgical procedures, submitting insurance claims, and managing the billing process for a fertility practice or healthcare facility. They ensure compliance with healthcare regulations and maximize revenue by optimizing reimbursement.
General Summary of Duties:
Responsible for gathering charge information, coding, entering into data base
complete billing process and distributing billing information. Responsible for
processing and filing insurance claims and assists patients in completing
insurance forms.
Essential Functions:
o Prepare and submit insurance claims accurately and in a timely manner.
o Verify patient insurance coverage and eligibility for fertility services( treatments and surgical procedures).
o Review and address coding-related denials and discrepancies.
o Researches all information needed to complete billing process including getting charge information from physicians.
o Assists in the processing of insurance claims
o Processes all insurance provider’s correspondence, signature, and insurance forms.
o Assists patients in completing all necessary forms, to include payment arrangements made with patients. Answers patient questions and concerns.
o Keys charge information into entry program and produces billing.
o Processes and distributes copies of billings according to clinic policies.
o Records payments for entry into billing system.
o Follows-up with insurance companies and ensures claims are paid/processed.
o Resubmits insurance claims that have received no response or are not on file.
o Works with other staff to follow-up on accounts until zero balance.
o Assists error resolution.
o Maintains required billing records, reports, files.
o Research return mail.
o Maintains strictest confidentiality.
o Other duties as assigned
o Identify opportunities to optimize revenue through accurate coding and billing practices.
o Assist in developing strategies to increase reimbursement rates and reduce claim denials.
Benefits:
Kofinas Fertility group, offers nationally competitive compensation and benefits. Our benefits program provides a comprehensive array of services to our employees including, but not limited to health insurance (Primarily covered by the company), paid time off, retirement contributions (401k), & flexible spending account
Work Environment:
The work environment characteristics described here are representative of those and employee encounters while performing the duties of this job. Kofinas Fertility Billing Service provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, and gender identity. Complies with applicable state and local laws governing nondiscrimination in employment in every location in which the practice has facilities. This applies to all terms and conditions of employment including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.
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