Pediatric Medical Billing Specialist
4 weeks ago
Job Summary:
We are seeking a highly skilled Pediatric Medical Billing Specialist to join our team at Patterson Schlotterer Medical Group. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely processing of medical claims.
Key Responsibilities:
- Oversee daily processing and submission of claims from our practice management system to the clearinghouse and third-party payors.
- Continuously work the A/R and denials to prevent losses from timely filing and research denials to keep us informed accordingly.
- Proactively monitor for errors and issues and promptly resolve them to ensure payments are processed as not to exceed the timely filing rules.
- Resolve edits related to coding; obtain and review relevant documentation and ensure documentation supports services billed.
- Oversee the insurance correspondences, such as Explanation of Benefits (EOB) and Coordination of benefits and researches appropriate claims steps, such as first or second appeal.
- Communicates with insurance carriers to track and check status of appeals.
- Work with insurance payors to ensure timely and accurate payments.
- Troubleshoot patient account issues, including direct resolution of billing issue with patients.
- Ensure accurate patient statements are sent out monthly along with analyzing patients accounts and recommend to collections accordingly.
- Ensure credentialing and privileging is accurately maintained with all payors and facilities, including the re-credentialing cycle.
Requirements:
- Pediatric experience: 1 year (required)
- Medical billing experience: 2 years (required)
- EClinical Works experience (preferred but not required)
Work Environment:
This is a full-time position. Punctuality and forward thinking are a must.
Job Type: Full-time / In-person
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