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Healthcare Billing Specialist

2 months ago

Cincinnati, Ohio, United States Mayfield Brain and Spine Full time
Job Overview

Qualifications:

  • High School Diploma required
  • A minimum of two years of recent experience in healthcare billing or Revenue Cycle Management is essential

Key Competencies:

  • Exceptional customer service skills
  • Ability to demonstrate empathy towards patients
  • Strong analytical and decision-making abilities
  • Proficient in managing multiple priorities in a dynamic environment
  • Excellent verbal and written communication skills
  • Capable of interpreting insurance Explanation of Benefits
  • Ability to maintain professionalism in high-pressure situations
  • Good judgment and diplomacy in interactions
  • Team-oriented mindset with a collaborative spirit
  • Proficient in computer applications with a willingness to learn new software
  • Ability to work independently with minimal oversight

Core Responsibilities:

  • Foster a corporate culture that aligns with the mission and values of Mayfield Brain and Spine
  • Accurately submit electronic and paper claims in a timely manner
  • Engage directly with payers on unresolved claims, ensuring all inquiries are handled professionally to facilitate resolution and reimbursement. Share updates regarding insurance policy changes with the team and relevant departments.
  • Manage first-level appeals: Prepare and submit appeals for denied claims with the objective of overturning denials and securing appropriate reimbursement.
  • Prioritize claims based on aging and outstanding amounts, or as directed by management.
  • Maintain thorough documentation and update the practice management system with relevant claims submission details and actions taken.
  • Verify insurance coverage and input necessary information for denied claims. Provide insights to update the managed care database as required for new or changing insurance policies.