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Medical Billing and Coding Specialist

3 months ago


Wellington, United States The Derm Group Full time
Job DescriptionJob Description

Join Our Team as a Medical Coder and Biller

We are seeking experienced billing and coding specialists to work with our dermatology clients. Preferred candidates will have experience with EZ Derm and/or EMA (Modmed) and a minimum of 2 years of medical billing experience.

Responsibilities:

  • Post insurance and patient payments
  • Review claims prior to submission to insurance carriers
  • Verify and review patient information, insurance IDs, diagnosis and treatment codes, modifiers, and provider information to ensure completeness and accuracy
  • Submit insurance claims to clearinghouses or individual insurance companies electronically or via paper CMS-1500 forms
  • Prepare and submit secondary claims as needed after primary insurer processing
  • Address claim denials and manage accounts receivables using available payer resources
  • Respond to patient inquiries about payment responsibilities, copays, deductibles, write-offs, and resolve complaints or explain coverage issues
  • Prepare and mail patient statements for charges not covered by insurance on a regular basis
  • Work with patients to establish payment plans for past due accounts in accordance with provider policies
  • Perform "soft" collections for past due patient accounts
  • Adhere to HIPAA guidelines in handling patient information
  • Understand specialty authorizations and coverage limits, such as the number of visits
  • Occasionally verify patient benefits eligibility and coverage
  • Follow standard billing procedures, including CPT and ICD-10 coding rules and guidelines, and deductible/co-insurance determination
  • Familiarity with commercial payers’ claim processes and the fundamentals of coding

Qualifications:

  • CPC or CPB certification preferred
  • Bilingual skills are a plus