Medical Billing Specialist, Insurance Revenue Cycle

2 days ago


Tampa, Florida, United States Sherloq Solutions Full time
About Sherloq Solutions

Sherloq Solutions is a leading provider of revenue cycle services, dedicated to delivering exceptional results in the healthcare industry. Our team is passionate about helping healthcare providers and payers maximize their revenue and improve patient outcomes.

Job Summary

We are seeking a highly skilled Medical Billing Specialist, Insurance Revenue Cycle to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims, verifying patient and insurance information, and analyzing payer denials. If you have a strong background in medical claims billing and a passion for delivering exceptional results, we encourage you to apply.

Key Responsibilities
  • Resolve healthcare claims through verbal or online inquiries to health insurance payers.
  • Effectively navigate and utilize various healthcare provider software systems.
  • Verify patient, insurance, billing and claim submission information for accuracy.
  • Eligibility inquiries and coordination of benefits research, including reaching out to the patient when necessary.
  • Analyze payer denials and appropriately respond to secure claim reimbursement.
  • Provide information to the Billing & Appeals Specialists on claims that require written appeals.
  • Track trends in payer underpayments, coding issues and denials and report to leadership for escalation.
  • Recognize basic coding denials and request appropriate action for correction or dispute.
  • Check insurance payments for accuracy and compliance with contract discount.
  • Research missing payments and secure documents needed for posting.
Requirements
  • Excellent verbal and written communication skills.
  • Accurately read and interpret insurance explanation of benefits.
  • Computer proficiency with Microsoft Word, Excel, Outlook and other office software applications is required.
  • Ability to problem solve and think critically to identify trends.
  • Work well with others and promote a team environment.
  • Utilize time management skills to manage daily tasks and meet production & quality metrics.
Preferred Qualifications
  • A background in medical claims billing, insurance collections, coding, and/or denials management is desired.
  • Three (3) years of healthcare industry experience preferred.
  • High school diploma or equivalent required.
  • Obtain AAHAM Certified Revenue Cycle Specialist-Institutional accreditation within two years of employment. Other similar industry certifications accepted.

Sherloq Solutions is an equal opportunity employer and welcomes applications from diverse candidates. We maintain a drug-free workplace and perform pre-employment substance abuse testing. If you are a motivated and detail-oriented individual with a passion for delivering exceptional results, we encourage you to apply.



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