Medical Billing Specialist I

1 day ago


Baton Rouge, Louisiana, United States Premier Health Consultants Full time
Job Summary

Premier Health Consultants is seeking a highly skilled Medical Billing Specialist I to join our team. As a Medical Billing Specialist I, you will be responsible for taking all steps necessary to achieve complete account reconciliation. This includes possessing and applying a thorough knowledge of practice management billing systems and the ability to apply the knowledge to all aspects of the patient account, including insurance, billing, and collection.

Key Responsibilities
  • Possesses and applies a thorough knowledge of practice management billing systems and the ability to apply the knowledge to all aspects of the patient account, including insurance, billing, and collection.
  • Possesses and applies knowledge of CPT and ICD9 coding usage.
  • Obtains all necessary information for completing the billing process, including charge information from the physician.
  • Generates and submits collection notices and follows up on all patients due collection levels.
  • Makes determination of possible assignment to outside collection agencies by complying with self-pay and bad debt policies.
  • Proactively researches and understands billing issues to troubleshoot the front-end processes that cause the problems.
  • Identifies coding errors and insures that charges are properly bundled or unbundled.
  • Understands the coding requirements for the governmental and commercial payers.
  • Proactively identifies any changes in billing requirements to any governmental and commercial payors.
  • Keeps the practices and billing office staff up to date with these changes.
  • Monitors the accounts for any registration / front end errors and makes the supervisor and practice informed of repetitious ones as well as assists with training the practice to reduce these types of errors.
  • Promptly answers inquiries from patients, co-workers, and supervisors regarding patient accounts in a kind and courteous manner.
  • Assists in providing quality training and orientation for assigned employees.
  • Posts and balances all payments, adjustments and denials received on EOBs or ERAs in an accurate and timely manner.
  • Reports any unidentified payments to the audit control coordinator.
  • Promotes and maintains harmonious and effective relationships while communicating within the department and between the department and other areas.
  • Assist with claims submission by pulling EOBs for secondary claims and any claims that require additional documentation.
Requirements
  • High school or equivalent with 1 year of medical billing or office experience.
  • Ability to read, analyze, and interpret general governmental regulations.
  • Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  • Knowledge of EMR systems, Excel Spreadsheet software and MS Word Processing software.
  • Clinical license and certification preferred, but not required.
Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually quiet to moderate. The employee may be exposed to infectious or contagious diseases and a variety of electromechanical hazards. The employee may also handle emergency and/or crisis situations.



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