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Healthcare Billing Specialist

2 months ago

Rochester Hills, Michigan, United States Doctors for Kids, PLC Full time
Position Overview

The Healthcare Billing Specialist is tasked with overseeing the billing and coding operations, processing insurance claims, and addressing patient billing questions. The successful candidate will have a comprehensive understanding of healthcare billing methodologies, coding frameworks, and insurance guidelines, along with strong organizational and communication abilities.

Primary Duties:

  • Billing and Coding: Precisely code and manage medical claims utilizing ICD-10, CPT, and HCPCS coding systems. Ensure compliance with prevailing regulations and payer stipulations.
  • Claims Processing: Prepare and dispatch claims to insurance providers and governmental payers. Confirm patient details, insurance eligibility, and benefits.
  • Claims Management: Track and follow up on pending claims, denials, and rejections. Address issues with insurance providers and resubmit corrected claims as necessary.
  • Patient Billing Support: Create patient invoices, process payments, and handle patient billing inquiries. Assist patients in comprehending their bills, payment methods, and insurance coverage.
  • Financial Reconciliation: Reconcile received payments against billed services and maintain precise records of all transactions. Generate financial reports as required.
  • Regulatory Compliance: Remain updated on changes in billing practices, insurance policies, and healthcare regulations to ensure adherence.
  • Client Relations: Deliver exceptional customer service to patients, addressing billing concerns with professionalism and empathy.
  • Documentation Accuracy: Ensure all billing and coding documentation is thorough and precise. Collaborate with healthcare providers to obtain necessary documentation and rectify coding discrepancies.

Required Qualifications:

  • Education: High school diploma or equivalent is required; an associate's or bachelor's degree in healthcare administration, medical billing, or a related discipline is preferred.
  • Experience: At least 3 years of experience in medical billing or coding. Experience in a pediatric medical specialty or environment is advantageous.
  • Certification: Certification from a recognized medical billing and coding organization (e.g., AAPC, AHIMA) is preferred but not mandatory.
  • Essential Skills:
    • Thorough knowledge of medical billing codes, insurance processes, and payer requirements.
    • Strong attention to detail and precision.
    • Excellent organizational and time-management capabilities.
    • Effective written and verbal communication skills.
    • Proficiency in medical billing software and electronic health records (EHR) systems.
    • Ability to manage sensitive information with confidentiality and professionalism.

Employee Benefits:

  • Competitive salary package
  • Health, dental, and vision insurance coverage
  • Retirement savings plan options
  • Paid time off benefits