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Medical Biller Revenue Cycle Specialist
1 month ago
- Bonus based on performance
As an In-House Medical Biller, you will be responsible for managing and maintaining the billing process for our medical practice. This includes generating invoices, submitting claims to insurance companies, following up on outstanding balances, and ensuring timely and accurate payment. The ideal candidate will have a strong understanding of medical billing processes, insurance regulations, and a commitment to providing excellent customer service to both patients and colleagues.
Responsibilities:
- Process medical claims and submit them to insurance companies in a timely manner.
- Review patient accounts to ensure accurate billing information, including demographics, insurance details, and procedural codes.
- Follow up on unpaid claims and denials, working with insurance companies to resolve discrepancies and secure payment.
- Research and appeal denied claims by gathering appropriate documentation and submitting it to insurance companies for reconsideration.
- Maintain accurate and up-to-date records of billing activity, including payments, adjustments, and patient account balances.
- Generate and send patient statements, addressing any billing questions or concerns from patients and their families.
- Collaborate with healthcare providers and administrative staff to ensure accurate coding and documentation for services rendered.
- Monitor and analyze billing trends to identify areas for process improvement and revenue optimization.
- Stay informed of changes in insurance policies, coding guidelines, and industry best practices.
- Perform other related duties as assigned.
Qualifications:
- Bachelor's degree in a related field preferred.
- Mandatory of 5 years of experience in medical billing in the following areas: Medicare /medicaid, private insurance, Methadone, IOP, OP, counseling services and Behavioral Health services.
- Forensic Medical Billing Experience
- Strong knowledge of medical terminology, ICD-10, and CPT coding.
- Familiarity with insurance claim processing, reimbursement procedures, and compliance regulations.
- Proficient in using electronic health records (EHR) and billing software.
- Excellent attention to detail and ability to multitask in a fast-paced environment.
- Strong problem-solving, analytical, and critical thinking skills.
- Exceptional communication and customer service skills.
- Ability to work both independently and as part of a team.
- Knowledge of HIPAA and other privacy regulations.
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