Medical Billing Specialist

3 weeks ago


Sedalia, Missouri, United States Katy Trail Community Health Full time
Job Summary

We are seeking a highly skilled Medical PA Billing Specialist to join our team at Katy Trail Community Health. The successful candidate will be responsible for handling all types of insurance claims, including private, Medicare and Medicaid, and will work cooperatively with Clinic providers and support personnel to accomplish all goals and objectives of the organization.

Key Responsibilities
  • Insurance Claims Management: Handle all types of insurance claims, including private, Medicare and Medicaid, and ensure timely and accurate processing to ensure proper reimbursement for services provided.
  • Authorization and Pre-Authorization: Obtain prior authorization for in-house procedures and ensure all pre-authorizations have been approved with the proper procedure code prior to services being rendered.
  • Coding and Billing: Provide a quality review and analysis of patient medical records to ensure accuracy of coding and maintain records with accepted medical and legal standards.
  • Accounts Receivable: Support organizational financial sustainability by performing accurate and timely accounts receivable functions, including filing claims, submitting patient bills for payment, and posting payments/remittances to patient accounts.
Requirements
  • Education and Certification: Minimum of high school diploma or equivalent, some college coursework and/or other specialized and relatable training preferred. CPC or other billing certification preferred.
  • Knowledge and Skills: Working knowledge of coding & billing functions of third party payer system, including Medicare, Medicaid, and commercial insurance. Current knowledge of ICD-10 diagnostic and CPT-5 procedural coding applications. Ability to accurately record and transmit detailed information, interpret and comply with applicable regulations, and demonstrate effective organizational skills and time management skills.
  • Communication and Interpersonal Skills: Effective interpersonal and communication skills, both in verbal and written form, with an outstanding customer service mindset.


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