Medical Billing Specialist

Job Description – MEDICAL BILLER DUTIES:

• Obtaining referrals and pre-authorizations as required for procedures.
• Checking eligibility and benefits verification for treatments and procedures.
• Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary.
• Knowledge of Texas Medicaid.
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating billing software with rate changes.
• Updating cash spreadsheets, and running collection reports.
• Knowledge of insurance guidelines including HMO/PPO, Medicaid and other payer requirements and systems.
• Competent use of computer systems and software.
• Familiarity with CPT and ICD-10 Coding.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Ability to work well in a team environment. Being able to triage priorities, and handle conflict in a reasonable fashion.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to multitask while maintaining attention to detail.

QUALIFICATIONS: Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred. A minimum of three years of billing experience in a medical office setting. EMR system experience with eClinicalWorks preferred. Bilingual preferred.

Job Type: Full-time

Pay: $16.50 - $22.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Education:

• Associate (Preferred)

Experience:

• ICD-10 coding: 1 year (Required)
• Medical Billing: 3 years (Required)

Work Location: One location