Medical Billing Specialist

1 month ago

Carrollton, United States DFW Healthcare MSO Full time
Job DescriptionJob Description

Medical Billing Specialist

Company Overview:

IntraCare Health Center (DFW Healthcare MSO) serves multiple healthcare organizations across the greater Dallas-Ft. Worth and Phoenix area. Under the guidance of an exceptional leadership team, we've consistently delivered a decade of outstanding performance and service excellence in value-based care, clinic operations, and lab services.

At IntraCare, we foster an exceptional workplace culture. We value inclusivity, respect diverse perspectives, and encourage healthy debate. We don't just hire employees; we welcome partners who become integral members of our IntraCare family. We empower our team members to reach their full potential, believing that individual development fuels collective success.

Key Responsibilities:

  • Strategic Collaboration: Forge strong partnerships with healthcare providers and administrative staff to ensure seamless and efficient billing processes. Your role is pivotal in facilitating clear communication channels between various stakeholders, optimizing revenue cycles, and enhancing overall operational efficiency.
  • Meticulous Billing and Coding: Execute precise billing and coding tasks across multiple practices and geographic locations. Your attention to detail and comprehensive understanding of coding standards will be instrumental in accurately translating medical services into billable claims, thereby maximizing reimbursements and minimizing compliance risk.
  • Technological Proficiency: Leverage advanced Electronic Medical Record (EMR) systems to capture charges accurately and ensure proper sequencing of medical procedures. Your adeptness with EMR platforms, particularly Athena, will empower you to navigate complex billing workflows with ease and agility, enhancing both accuracy and efficiency in revenue capture processes.
  • Documentation Mastery: Serve as a guardian of documentation integrity by meticulously reviewing and interpreting medical records. Your expertise in deciphering clinical documentation will play a critical role in ensuring that billed services align closely with documented patient encounters, thus safeguarding against potential audit liabilities and compliance breaches.
  • Continuous Process Improvement: Collaborate proactively with the billing team to identify areas for process enhancement and optimization. Your insights into billing workflows, coupled with your problem-solving acumen, will drive continuous improvement initiatives aimed at streamlining revenue cycle operations, reducing billing errors, and enhancing overall revenue performance.
  • Empowering Support: Extend proactive coding support to medical offices, offering guidance and assistance to optimize coding accuracy and efficiency. Your role as a coding mentor and resource person will empower healthcare providers and staff to navigate coding complexities with confidence, fostering a culture of continuous learning and skill development within the organization.

Required Skills and Abilities:

  • Coding Mastery: Demonstrate a minimum of 2 years' proficiency in medical coding, with a strong emphasis on Evaluation and Management (E/M) and Procedural Coding. Your mastery of coding conventions, guidelines, and regulations will be pivotal in ensuring accurate code assignment and compliance with payer requirements.
  • Certification Excellence: Possess current CPC certification, reflecting your commitment to upholding the highest standards of professional competency and ethical conduct in medical coding practices. Your certification status will underscore your credibility as a trusted coding professional within the healthcare community.
  • Regulatory Compliance: Exhibit a thorough understanding of coding frameworks, including CPT, HCPCS, and ICD-10-CM, as well as familiarity with Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and National Correct Coding Initiative (NCCI) edits. Your compliance expertise will mitigate billing errors and mitigate regulatory risks, ensuring adherence to industry best practices and payer guidelines.
  • Payer Proficiency: Navigate the complex landscape of healthcare payers with confidence, demonstrating proficiency in Medicare, Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Medicare Advantage Plans. Your comprehensive knowledge of payer policies and reimbursement methodologies will optimize revenue capture and facilitate timely claims adjudication.
  • Analytical Acumen: Apply strong analytical skills and attention to detail in analyzing clinical documentation and assigning appropriate codes. Your ability to discern subtle nuances in medical records and apply coding guidelines judiciously will ensure accurate claim submissions and facilitate optimal reimbursement outcomes for healthcare providers.
  • Autonomous Execution: Operate with a high degree of independence and reliability in managing workload and making informed decisions. Your self-directed approach and proactive mindset will enable you to navigate complex billing scenarios effectively, driving operational excellence and delivering results in a dynamic healthcare environment.

Education and Experience:

  • Educational Foundation: Possess a high school diploma or equivalent qualification, supplemented by specialized training in medical coding and billing practices. Your educational background will provide a solid foundation for mastering the intricacies of medical billing processes and advancing your career in healthcare revenue cycle management.
  • Technical Aptitude: Exhibit proficiency in utilizing computer applications, including the Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel), to facilitate documentation, communication, and data analysis tasks. Your technical aptitude will enable you to leverage technology effectively in executing billing and coding responsibilities, enhancing productivity and performance outcomes.
  • Customer-Centric Approach: Cultivate strong customer service skills and demonstrate comfort in engaging with patients and insurance companies to address inquiries and resolve billing-related issues. Your ability to communicate effectively and empathetically will foster positive relationships with stakeholders and contribute to exceptional patient experiences within the healthcare ecosystem.
  • Problem-Solving Prowess: Demonstrate agility in analyzing problems and devising strategic solutions to overcome billing challenges and optimize revenue performance. Your problem-solving prowess will be instrumental in navigating complexities inherent in medical billing operations, driving continuous improvement, and achieving organizational objectives.

Job Type: Full-time

Location: Hybrid after successful training and development

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