Medical Billing Specialist

3 weeks ago

Tustin, United States Medusind Full time
At Medusind we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry. A significant factor is that our workforce comes with a rich domain expertise and robust compliance norms.
Our four-prong approach of an excellent management team coupled with detailed eye for processes, experienced manpower, and cutting-edge technology helps us deliver superior, cost-effective services to our clients across the globe.
Benefits:
  • Health insurance.
  • Dental insurance.
  • Vision insurance.
  • Employer paid life insurance.
  • Employer paid short-term and long-term disability.
  • Voluntary additional life insurance.
  • Employee Assistance Program.
  • 48 hours of sick time after three months.
  • 80 hours of vacation time after six months.
  • $400 referral bonuses.
Duties include but are not limited to:
  • Auditing and Compliance Analysis
    • Conduct detailed audits on claims and billing submissions to ensure accuracy, completeness, and compliance with payer-specific guidelines, including Medicare and Medicaid regulations.
    • Identify trends in claim denials and recommend corrective actions to improve billing processes and compliance.
  • Claims Submission 
    • Prepare and submit claims for behavioral health services, ensuring they meet all payer requirements for accuracy and timeliness.
    • Track and analyze claims submission outcomes, identifying patterns in denials and rejections, and developing strategies to mitigate issues for assigned accounts.
    • Maintain regular follow-up on claim submission, ensuring prompt resolution of incomplete, not on file or rejected claims. 
  • Billing and Charge Review
    • Review and analyze charges for behavioral health services to verify they align with payer policies, applicable coding standards, and the specifics of patient coverage.
    • Validate patient eligibility, benefits, and authorization information provided by team members to proactively prevent claim rejections and ensure timely reimbursement.
    • Reconcile billing discrepancies by researching charge inconsistencies, payments, and adjustments to ensure accurate financial records.
  • Team Collaboration and Resource Support
    • Act as a resource for the internal teams, providing insight into billing policies and statuses, compliance requirements, and efficient use of billing software systems.
    • Train and support team members on best practices in auditing, claims submission, and payer regulations to foster knowledge-sharing and process improvement.
    • Collaborate with clinical and administrative staff to ensure billing accuracy and documentation compliance, identifying any gaps or improvements needed in processes.
Requirements:
  • Education: High school diploma or equivalent required; Associate degree or certification in medical billing/coding preferred.
  • Experience:
    • Minimum of 3-5 years of experience in medical billing, with a focus on behavioral health services preferred.
    • Demonstrated proficiency with Medicare, Medicaid, and commercial insurance billing, particularly in auditing and claims analysis.
  • Skills:
    • Strong expertise in billing software and electronic billing systems.
    • Analytical mindset with exceptional attention to detail, problem-solving, and organizational skills.
    • Effective communication skills, with the ability to clearly convey complex billing issues and analysis findings.
    • Ability to work independently, prioritize tasks, and act as a collaborative team member.


About Medusind:

Since 2002, organizations across the entire healthcare spectrum have leveraged our deep expertise and high-quality solutions to maximize revenue, reduce operating costs and navigate the changing healthcare landscape.Medusind’s unique combination of deep industry expertise, robust operational capability, and client-focused service significantly improves the efficiency and profitability of healthcare organizations. Client satisfaction is the primary focus of the Medusind leadership and staff.Our highly experienced personnel, cutting edge technology, and forward thinking approach allows us to deliver effective solutions while staying ahead of healthcare industry changes.

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