Medical Billing Specialist

6 days ago

Stanford, California, United States DFRG LLC Full time
Job Overview

We are seeking an experienced Medical Billing Associate to join our team at DFRG LLC. As a key member of our healthcare team, you will be responsible for ensuring accurate and timely billing and coding of patient services.

Key Responsibilities
  • Billing and Coding:
    • Accurately assign CPT, ICD-10, and HCPCS codes to patient services.
    • Enter and submit claims to insurance companies electronically or via paper submissions.
    • Review and verify patient billing data to ensure accuracy and completeness.
  • Claims Management:
    • Monitor and follow up on outstanding claims to ensure timely reimbursement.
    • Analyze and resolve billing errors and claim denials.
    • Appeal denied claims and resubmit with appropriate documentation.
  • Insurance Verification:
    • Verify patient insurance coverage and eligibility.
    • Obtain prior authorizations and referrals when necessary.
    • Communicate with insurance companies to clarify billing discrepancies.
  • Patient Account Management:
    • Generate and distribute patient statements and invoices.
    • Respond to patient inquiries regarding billing and account status.
    • Set up payment plans according to company policies.
  • Compliance and Reporting:
    • Ensure compliance with HIPAA and other regulatory requirements.
    • Maintain up-to-date knowledge of billing regulations and industry best practices.
    • Prepare regular reports on billing activities, collections, and account receivables.
Qualifications
  • Experience:
    • Minimum of 5 years of medical billing experience in a healthcare setting.
  • Certifications:
    • Certified Professional Biller (CPB) or Certified Professional Coder (CPC) certification preferred.
  • Skills and Abilities:
    • In-depth knowledge of medical billing procedures, insurance policies, and regulations.
    • Proficiency in CPT, ICD-10, and HCPCS coding.
    • Strong analytical skills and attention to detail.
    • Excellent communication and interpersonal skills.
    • Ability to handle sensitive information with confidentiality.
    • Proficient in Microsoft Office Suite (Word, Excel, Outlook).

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