Medical Billing Specialist

3 weeks ago


Huntington Beach, California, United States Vensure Employer Solutions Full time

Job Summary

Vensure Employer Solutions is seeking a highly skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will be responsible for processing medical claims, collecting patient or provider payments, and resolving questions and problems with customer accounts.

Key Responsibilities

  • Review clinical documentation to ensure support for codes billed.
  • Edit appropriate modifier usage & diagnosis codes for accurate claims submission.
  • Review all rejected claims for corrections.
  • Apply patient payments to claims created.
  • Process medical data relevant to medical billing, charge entries, payment posting, and update the electronic medical records system.
  • Review rejected claims and take necessary steps to finalize claim, including reverification of insurance, obtaining prior authorizations, contacting Payor, physician offices & patients.
  • Ensure copays 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.

Requirements

  • 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.
  • 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-10 codes, 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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