Medical Billing Specialist

1 day ago


Toms River, New Jersey, United States Ocean Plastic Surgery PA Full time
Job Summary

The Medical Biller will be responsible for managing the billing and coding processes for surgical procedures performed at Ocean Plastic Surgery PA. This role involves handling patient accounts, ensuring accurate coding, processing claims, and working with insurance companies to resolve any issues.

Main Responsibilities

  • Billing and Coding:
    • Achieve accuracy in coding and billing all surgical procedures and related services using ICD-10, CPT, and HCPCS codes.
    • Verify the completeness and accuracy of patient information and insurance details before processing claims.
  • Claim Management:
    • Submit insurance claims electronically or manually, as required, and ensure timely follow-up on unpaid or denied claims.
    • Monitor claim status and resolve any discrepancies or issues with insurance companies.
  • Patient Interaction:
    • Communicate with patients regarding billing inquiries, payment plans, and account balances.
    • Address and resolve any billing disputes or questions from patients in a professional manner.
  • Insurance Verification:
    • Verify patient insurance eligibility and benefits prior to surgery and ensure that pre-authorizations are obtained when necessary.
  • Record Keeping:
    • Maintain accurate and up-to-date patient billing records and documentation.
    • Ensure compliance with all federal, state, and local regulations related to medical billing and coding.
  • Reporting:
    • Generate and review billing reports to identify trends, potential issues, and opportunities for process improvement.

Requirements

  • A high school diploma or equivalent; an Associate's degree in medical billing and coding or a related field is preferred.
  • Certification in Medical Billing and Coding (e.g., CPC, CBCS) is preferred.
  • Proven experience in medical billing and coding, preferably in a surgical or clinical setting.
  • Strong knowledge of medical terminology, coding procedures, and insurance protocols.
  • Proficiency in medical billing software and electronic health record (EHR) systems.
  • Excellent attention to detail, organizational skills, and the ability to manage multiple tasks simultaneously.
  • Strong communication skills and a professional demeanor.

Estimated Salary: $65,000 - $85,000 per year



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