Medical Billing Specialist
Responsible for following up on denied and rejected claims, entering any charge corrections accurately into the billing system. Codes ICD-10 as needed, for entry of charges into system for all billable procedures, visits, tests, consultations, etc. Post incoming insurance and patient patients through EMR system.
- Ensures complete accuracy of data entry of charges and payments
- Compiles charge information and assists in coding when needed. Ensures charge information provided is correct and accurate.
- Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
- Keeps supervisor apprised of matters regarding charge entry or claims denials/rejections
- Follows coverage guidelines for coding.
- Keeps current with third party/payers specific coding and billing guidelines
- Strong customer service skills; answering client calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally.
- General working knowledge and learning attitude to add specific data such as modifiers, payer specific information including authorizations criteria, CPT, and ICD-10 codes and date of injury (DOI).
- Follow up on claim denials and rejections from insurance companies
- Resubmit corrected claims if necessary
- Post insurance payments from mail and EFT (electronic funds transfer)
- Post patient payments
- Researches and analyzes accounts and payments to determine if charges were billed properly to support medical charges including medical records
- Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES
- High School Diploma or GED required
- Certificate from an accredited program (preferred)
- Minimum of two years-experience in medical billing experience (preferred)
- Knowledge of and understanding of CPT/HCPCS and ICD-10
- Knowledge of Medical Terminology, Anatomy and Physiology required
- Microsoft Office experience required
- Denial follow up experience
- Strong attention to detail and ability to problem-solve.
- Familiarity with EMR systems/Medical Billing Software.
- General insurance knowledge.
- Detailed understanding of an EOB
- Payment posting experience required
- Other duties as assigned
· Office Environment
· The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
· While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.
· The employee must be able to life and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.
· The employee must be able to stand and/or walk at least five hours per day.
· The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job Types: Full-time, Part-time
- Dental Insurance
- Health Insurance
- Life Insurance
- Paid Time Off
- Vision Insurance
- 12 Hour Shift
- Day shift
- Monday to Friday
- Night Shift
- Coding/Hospital Billing: 3 years (Preferred)
- Associate (Preferred)