Medical Billing Specialist

3 days ago


Huntington Beach, California, United States Vensure Employer Services Full time
Medical Billing & Back Office Specialist

We are seeking a highly skilled and detail-oriented Medical Billing & Back Office Specialist to join our team at Vensure Employer Services. As a key member of our operations team, you will play a critical role in ensuring the accuracy and efficiency of our medical billing processes.

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, to include 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.
Qualifications:
  • 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.
    • When information is incomplete; purging files to eliminate duplication of data.
    • 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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