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Medical Billing Specialist
3 months ago
Role Description
This is a full-time on-site role for a Medical Billing Specialist. As a Medical Billing Specialist, you will play a crucial role in ensuring the financial health of our customers. We seek individuals with a strong work ethic, excellent problem-solving skills, and a genuine passion for medical billing. Your responsibilities will include managing insurance communications, reconciling insurance EOBs and payments, maintaining patient confidentiality, managing denials, utilizing ICD-10 codes, verifying insurance information, and working with commercial and government insurance providers. Due to the nature of the healthcare industry, a high degree of professionalism and attention to detail is essential.
Responsibilities
- Function as a subject matter expert in support of other billing team members.
- Demonstrate a good understanding of payer benefits requirements, claims status, submissions of claims, insurance follow-up, payment posting, and reconciliation procedures.
- Approve or deny requested adjustments and refunds within role thresholds.
- Manage and resolve denied, adjusted, or underpaid procedures on insurance accounts to reduce Accounts Receivable.
- Prepare and submit electronic and paper claims to insurance companies.
- Collaborate with multiple clinics and providers to rectify demographic errors.
- Communicate effectively with insurance companies, adjusters, and third-party payers via phone, email, and other channels.
- Analyze insurance EOBs to ensure correct payment for all procedures.
- Identify trends and issues with various payers and propose solutions for resolution.
- Process and post insurance payments promptly.
- Submit insurance claims to payers in a timely manner, adhering to compliance regulations.
- Ensure compliance with relevant state and federal agencies.
- Ensure quality and productivity standards are met or exceeded.
- Perform other related duties as assigned.
Skills
- A minimum of 3 years’ experience as a medical biller, collector, or a similar role.
- Adapt to process and procedure evaluations and improvements, support continuous change, and willingly manage special projects in addition to normal workload and other duties as assigned.
- Adaptability to change and ability to prioritize tasks effectively in a fast-paced environment.
- Proficiency with office management tools, particularly Microsoft Office software.
- Exceptional organizational and time-management skills.
- Outstanding written and oral communication abilities.
- Detail-oriented and problem-solving mindset.
- Ability to translate and analyze data into reports.
- Excellent interpersonal and supervisory skills.
- Ability to act with discretion, tact, and professionalism in all situations.
- Ability to maintain records and produce reports.
- Extreme attention to detail.
Preferred Qualifications
- Knowledge and proficiency with the billing system of "Tebra or Kareo" is a big plus.
- Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) certification is a plus.
