Medical Billing Specialist

We are currently seeking a highly motivated and detail-orientedMedical Billing Specialistto join our dynamic team. If you possess a strong understanding of insurance processes, excellent communication skills, and a proactive approach to resolving billing challenges, we encourage you to apply!

Responsibilities:

• Proactive Insurance Follow-Up:Diligently follow up with insurance companies via phone and email on all pending claims to ensure timely processing and payment.
• Denied/Underpaid Claim Resolution:Thoroughly investigate denied or underpaid claims, identify root causes, and implement effective solutions for efficient resolution, including preparing appeals and corrected claims.
• Timely Claim Submission & Resubmission:Ensure accurate and timely initial claim submissions and prompt resubmission of corrected claims to maximize reimbursement.
• Comprehensive Documentation:Accurately and thoroughly document all interactions with insurance companies, including phone calls, emails, and resolutions, within the billing system.
• Collaboration with Billing Team:Work closely with medical coders and other billing team members to identify and resolve coding errors, payment discrepancies, and other billing-related issues.
• Insurance Knowledge Maintenance:Continuously maintain up-to-date knowledge of various insurance policies, coverage guidelines, and billing procedures for different payers.
• Escalation of Unresolved Issues:Identify and escalate complex or persistently unresolved claims to the appropriate department for further investigation and action.
• Denial Trend Analysis:Analyze trends in claim denials to identify recurring issues and provide valuable feedback to improve overall billing processes and prevent future denials.
• HIPAA and Compliance:Adhere strictly to all HIPAA regulations and healthcare industry standards to ensure the privacy and security of patient information.

Requirements:

• Bachelor's Degree:A Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field is required.
• Insurance KnowledgeandBilling Software Proficiencypreferred.
• Communication Skills:Excellent verbal and written communication skills, including professional phone etiquette and the ability to communicate effectively with insurance representatives and colleagues.
• Analytical and Problem-Solving Abilities:Strong analytical skills to investigate claim issues, identify root causes, and develop effective solutions.
• Organizational Skills and Detail-Oriented:Exceptional organizational skills and meticulous attention to detail to manage multiple claims and ensure accuracy in all tasks.
• Computer Skills:Proficient in basic computer applications, including email, word processing, and spreadsheets (e.g., Microsoft Excel).
• Understanding of Medical Coding Basics:Familiarity with CPT, ICD-10, and HCPCS coding concepts and their impact on billing.
• HIPAA Knowledge:Comprehensive understanding of HIPAA regulations and commitment to maintaining patient confidentiality.
• Professionalism and Teamwork:Ability to maintain a professional demeanor and work effectively as part of a collaborative billing team.