Medical Billing

1 week ago

Huntington Beach, United States Vensure Employer Services Full time

Position Summary

We are seeking a Medical Billing & Back Office Specialist who lives their core values of being caring, knowledgeable, and exceptional with a passion for serving our patients. This leader will exude positivity and demonstrate operational excellence, ownership of their business, and the expertise to act with a sense of urgency. Our team members deliver an impeccable patient experience and treat everyone like family. The Medical Billing & Back Office Specialist will be a trusted team member providing care to our patients and a trusted partner to the clinical team, center staff, and the Executive Leadership team.

Responsibilities

* Review clinical documentation to ensure support for codes billed.
* Edit appropriate modifier usage & diagnosis codes for accurate claims submission.
* Reviews all rejected claims for corrections.
* Applying patient payments to claims created.
* Position Purpose: To process medical billing claims, collect patient or provider payments, resolve questions and problems with a customer's account, process patient refunds, appeals to include re-determinations and resubmissions of billing to patient payers.
* Process medical data relevant to medical billing, charge entries, payment posting and update the electronic medical records system.
* Review rejected claims and taking necessary steps to finalize claim, to include reverification of insurance, obtaining prior authorizations, contacting Payor, physician offices & patients.
* Ensure copay's are collected or billed to appropriate Payor.
* Answer inbound billing phone calls as needed.
* Maintain confidentiality of all patient and financial information.
* Prepare various reports in Excel as instructed by Supervisors.
* Verify entered data by reviewing, correcting, deleting, or reentering data, combining data from multiple systems.
* Fulfill targets with diligence and responsibility.
* Manage Email and phone communication with clients and team members.
* Maintain operations by following compliance policies and procedures; reporting needed changes.
* Maintain customer confidence and protects operations by keeping information confidential.
* Contribute to team effort by accomplishing related results as needed.
* Exhibit professional excellence, teamwork and integrity.
* Performs other duties and tasks as assigned, depending on work schedules and priorities.

Qualifications

* Minimum Experience: 2 years' experience in medical billing, specifically charge entry and payment posting.
* Experience Plus: Knowledge of electronic medical records systems and experience in processing.
* When information is incomplete; purging files to eliminate duplication of data.
* The ability to effectively multi-task is a must.
* Knowledge of medical referrals, medical eligibility checks and document management.
* Knowledge of reimbursement guidelines, CPT and ICD-10codes, payor contracts and plans.
* Must have good computer/typing skills.
* Need good documentation skills.
* Should have a strong understanding of Microsoft Excel, Word and Email systems.
* Should have good command over spoken and written English.
* Attention to details and research expertise.
* A good team member with highly effective communication skills.
* Must have research skills on Internet.
* Experience, skills, proficiency in English and sincerity at work.
* High School graduation is required, and Medical Billing certification preferred
* Must be eligible to work in USA.

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