100 Revenue Cycle Medical Specialist

Immediate opening!!!  Musty have primary care billing experience!

Our work environment includes:
Modern office setting
Cross Training
Positive Environment
Benefits

The medical biller handles billing and collections with various insurance providers (i.e. BCBS, United Health, Medicaid, Tricare, Humana, Managed Care Plans etc.). Responsible for compiling data, computing fees, and maintaining billing records. Under direct supervision, performs complex data entry and related operations in posting payments from patients and third parties. Reviewing patient charts ensuring all billing parameters having been completed and covered for maximum payment.  Posts payments and credits in EHR system, while maintaining compliance and resolving account problems.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:  Other duties may be assigned.

- Assign appropriate medical codes using ICD-9 or ICD-10 coding systems
- Verify patient information, insurance coverage, and billing details
- Prepare and submit claims to insurance companies for reimbursement
- Follow up on unpaid or denied claims and resolve billing discrepancies
- Maintain confidentiality of patient information and adhere to HIPAA regulations
- Collaborate with healthcare providers and staff to ensure accurate and timely billing
- Review and analyze medical records and documentation to ensure accurate coding and billing
- Assign appropriate ICD-10/ Cpt codes to medical procedures and diagnoses
- Verify patient insurance coverage and process claims for reimbursement
- Monitor and track the status of submitted claims
- Investigate and resolve claim denials or rejections in a timely manner
- Collaborate with insurance companies to address any billing discrepancies
- Provide excellent customer service to patients regarding billing inquiries (EOBs)
- Collaborate with healthcare providers to resolve coding and billing discrepancies
- Stay up-to-date with changes in medical coding guidelines and regulations
- Maintain confidentiality of patient information and adhere to HIPAA guidelines
- Utilize various systems and software to input and retrieve coding information accurately

- Compiles/Submits required documentation for insurance audits/reviews.

- Communicates with patients or third-party representatives by telephone, fax, e-mail, or postal mail to verify accuracy of charges, investigate complaints, or to correct errors in accounts. Answers mail and telephone inquiries regarding rates, services, and procedures.

- Receives payments from third party payers, or from patients via check or credit card; posts and reconciles payments to ledgers.

- Reviews refunds and adjustments; reconciles, corrects, and applies adjustments to billing records.