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Billing Specialist
1 month ago
Job Summary: The Revenue Cycle Billing Specialist is responsible for managing and optimizing all phases of the revenue cycle to ensure accurate and timely billing and collection processes. This role requires a keen attention to detail, strong analytical skills, and the ability to work collaboratively with various departments to streamline revenue operations and maximize financial performance.
Key Responsibilities:
1. Billing and Coding:
o Prepare and submit accurate claims to insurance companies and patients.
o Ensure proper coding of services rendered using ICD-10, CPT, and HCPCS codes.
o Verify completeness and accuracy of billing information before submission.
2. Claims Management:
o Monitor and follow up on unpaid or denied claims.
o Resolve billing discrepancies and disputes with insurance companies.
o Conduct periodic audits of claims to identify and rectify errors.
3. Payment Posting:
o Post payments from insurance companies and patients accurately.
o Reconcile posted payments with bank deposits and billing records.
o Identify and process refunds or adjustments as needed.
4. Patient Account Management:
o Respond to patient inquiries regarding billing and insurance coverage.
o Assist patients with setting up payment plans and resolving account issues.
o Maintain up-to-date patient account information.
5. Compliance and Reporting:
o Stay current with changes in billing regulations, insurance guidelines, and coding standards.
o Ensure compliance with HIPAA and other regulatory requirements.
o Generate and analyze financial and operational reports to identify trends and areas for improvement.
o Work closely with the medical staff, administrative teams, and insurance companies to resolve billing issues.
o Provide training and support to staff on billing processes and procedures.
o Participate in regular team meetings to discuss workflow improvements and updates.
Qualifications:
· Education:
o Associate’s or Bachelor’s degree in Healthcare Administration, Finance, Accounting, or related field preferred.
o Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) certification is a plus.
· Experience:
o Minimum of 5 years of experience in medical billing, coding, and revenue cycle management.
o Experience with billing software and electronic health records (EHR) systems.
· Skills and Abilities:
o Strong understanding of medical billing and coding principles.
o Excellent analytical and problem-solving skills.
o Proficiency in Microsoft Office Suite (Excel, Word, Outlook).
o Exceptional communication and customer service skills.
o Ability to work independently and as part of a team.
o High degree of accuracy and attention to detail
