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Medical Billing Specialist

1 month ago

Parsippany, New Jersey, United States YASMESOFT INC Full time
Job Title: Medical Billing Specialist - Hospital

We are seeking a highly skilled Medical Billing Specialist to join our team at Yasmesoft Inc. The ideal candidate will have experience in hospital billing and a strong understanding of insurance regulations and reimbursement methodologies.

Job Summary

The Medical Billing Specialist will be responsible for collecting payments, following up on accounts, and billing allowance posting for assigned accounts. The successful candidate will have excellent communication and organizational skills, with the ability to work well individually and in a team environment.

Key Responsibilities
  • Collect payments and follow up on accounts to ensure timely resolution of outstanding claims
  • Billing allowance posting for assigned accounts
  • Working knowledge of insurance follow-up process and understanding of fundamental concepts in healthcare reimbursement methodologies
  • Understanding of government, Medicare, and Medicaid claims
  • Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax, or websites
  • Review and update all patient and financial information accurately as given
  • Verifies that information is accurate as to individual or insurance company responsible for payment of bill
  • Monitors all billings for accuracy, updating any that contain known errors
  • Monitors Medicaid/healthy options coupons to assure services are billed within expected timeframes
  • Bills all hospital services to primary insurer or patient correctly and within expected timeframe
  • Follows up with insurance companies on all assigned accounts within expected timeframe
  • Explains hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
  • Identify and report underpayments and denial trends
  • Ability to analyze, identify, and resolve issues causing payer payment delays Initiate appeals when necessary
  • Basic knowledge of healthcare claims processing including: ICD-9/10, CPT, and HCPC codes, as well as UB-04
  • Ability to manipulate Excel spreadsheets and communicate results
  • Meets and maintains daily productivity and quality standards established in departmental policies
  • Act professionally, cooperatively, and courteously with patients, insurance payors, co-workers, management, and clients
  • Perform special projects and other duties as needed by the management team
  • Maintain confidentiality at all times
  • Use, protect, and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Requirements
  • Experience in hospital/facility billing required
  • 2-3 years experience in insurance collections, including submitting and following up on claims
  • Ability to work well individually and in a team environment
  • Proficiency with Microsoft Office, including Excel and Word
  • Strong organizational, communication, and written skills
  • Basic math and typing skills
  • High School Diploma
  • Medical Billing and Coding certification preferred, but not required

This is a remote position.