Billing Specialist Ii

3 weeks ago

Temecula, United States Rancho Health MSO Full time

**Job Summary**:
The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

**Essential Job Duties**: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Reviewing medical documentation and billing for errors, to ensure a clean claim is submitted the first time.
- Fielding patient and staff billing questions.
- Follow up on unpaid and denied claims.
- Insurance and patient payment posting and reconciliation.
- Work cooperatively with others, including appropriate communication with patients, providers, support staff and administration.
- Comply with all company policies and procedures found in the employee handbook.

**Required education and experience**:The requirements listed below are representative of the knowledge, skills, and/or ability required.

**Minimum Education required**:

- High school graduate or equivalent.
- Medical billing or coding certification preferred.

**Minimum Experience Required**:

- Required 5 years of revenue cycle experience.
- Knowledge of Epic EMR software is a plus.

**Minimum Knowledge and Skills Required**:

- Understanding and proficient use of medical billing guidelines and regulations. Knowledge of regulations as set forth by CMS, OIG, commercial insurances, and other regulatory agencies.
- Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for billing and following up on open AR claims.
- Familiar with billing all major medical insurances, including Medicare, Tricare, and commercial payers.
- Ability to communicate effectively and congenially with patients and staff members in person and over the phone.
- Ability to exercise tact, initiative, and good judgement when interacting with patients and staff members.
- Work experience in Office 365 business tools such as Outlook, Excel, Word etc.
- Ability to navigate and accurately input within the Practice Management System
- Ability to navigate in the EMR and other source systems.
- Ability to accept supervision and feedback.
- Ability to look for patterns of events, provides feedback and solutions.
- Critical thinking and analytical skills to review accounts and medical documentation.

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