Medical Billing Specialist Onsite

5 days ago

Tomball, United States SynergenX Full time

SynergenX is looking for a Billing Specialist to join our team ONSITE, Not remote

General Description: Billing Specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, all rejections and denials, monitoring claims status, documenting related account activities, posting adjustments and collections of all commercial insurance payers. You are responsible of the accurate flow of medical billing information. This position will ensure healthcare providers are paid for medical services rendered. The Billing Specialist must possess critical thinking skills and understanding of commercial insurance payer payment methods to correctly record contractual adjustments. You are responsible for demonstrating proficiency with the billing system to ensure all functionality is utilized for the utmost efficient processing of claims. This position is highly visible and requires strong written and verbal communication with the ability to prioritize, plan, and multi-task with the department.

**THIS POSITION IS ONSITE MONDAY-FRIDAY 8AM-5PM IN THE HOUSTON, TX AREA. (77070) NO REMOTE CANDIDATES WILL BE CONSIDERED**

**_ PRIMARY RESPONSIBILITIES (others may be assigned):_**
- Coordinate and manage work of all billing and collection staff.
- Prepares and submits clean claims to third party payers either electronically or by payer.
- Coordinate the process of patient eligibility.
- Understand and follow all payer rules when setting up billing rules on account to ensure accurate claims.
- Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to commercial insurance payers.
- Enter appropriate data into the billing system by selecting the appropriate codes, diagnosis's, modifiers to complete the charge process.
- Contact center directors regarding procedures and other services billed to ensure proper coding.
- Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
- Responsible for ensuring the batch process for all coded charges.
- Works with patients to develop self-pay arrangements and payment plans when needed.
- Process and follow up on payer denials, consulting with the patient or provider as needed.
- Post payments in a timely manner.
- Work with the payers and other key A/R staff to resolve outstanding claim processing issues with a focus on over sixty-day balances.
- Research and resolve client and patient billing issues.
- Follow up on unpaid claims in a timely manner.
- Be prepared to account for action taken on patient accounts. Participate in meeting as instructed by management.
- Participate in personal development training and cross training as instructed by management.
- Ability to meet individual and team goals with mínimal errors as assigned by the billing manager.
- Uphold HIPAA compliance guidelines in relation to billing, collections, and PHI information.
- Maintain and test internal controls related to billing and collections.
- Review, coordinate, and update all compliance issues regarding federal, state, and local guidelines.
- Maintain Billing software system.
- Reconcile billings with accounts receivable ledger.
- Support internal and external audit process.
- Demonstrate continuous efforts to improve operations; decrease turnaround times; streamline work processes; and work cooperatively and jointly with internal departments to provide quality seamless customer service.
- Represent department and the organization favorably and in accordance with established Company standards and associate attributes at all times.
- Plan, evaluate, and improve the efficiency of business processes and procedures to enhance speed, quality, efficiency, and output.
- Review performance data that includes financial, sales, and activity reports and spreadsheets, to monitor and measure departmental productivity, goal achievement, and overall effectiveness.
- Manage the preparation and maintenance of reports necessary to carry out the functions of the department. Prepares periodic reports for management, as necessary or requested, to track strategic goal accomplishment.
- Communicate regularly with other managers, the director, vice president, president, and other designated contacts within the organization.

**_ QUALIFICATIONS:_**
- Excellent attention to detail
- Prior experience billing in sleep studies & CPAP preferred
- Ability to multi-task and consistently meet multiple deadlines.
- Strong verbal and written communication skills.
- Ability to work in a team environment.
- Strong customer-service orientation.
- Ability to use good judgment.

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