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Medical Billing Specialist
2 months ago
Sherloq Revenue Solutions is seeking a highly skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will play a critical role in ensuring the accuracy and efficiency of our revenue cycle processes.
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 Revenue Solutions is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
Any applicant who, because of a disability, needs accommodation or assistance in completing an application or at any time during the application process should contact the Human Resources department. Sherloq Revenue Solutions also provides reasonable accommodations to employees with disabilities consistent with its obligations under the law.
Background and drug screen are required for employment.
