Medical Billing Specialist

The Medical Billing Specialist is responsible for overseeing the billing department's day-to-day functions of the 'Ekahi Health Systems (EHS). EHS is comprised of physicians and providers that include- Internal Medicine, Pediatrics, General Surgery, OB/GYN, Registered Dieticians, Behavioral Health Specialist, Psych-D and Pharmacists. The position focuses on but is not limited to, timely submission and payments of patient medical insurance claims, billing inquires and disputes from patients and insurance companies, and patient collections.

DUTIES AND RESPONSIBILITIES

• 
  Assist staff with billing issues.
• Advise and resolve provider billing issues.
• Review and enter of provider charges for patient claims.
• Insurance denial follow-up
• Call insurance companies to verify or appeal claims.
• Call patients to update information needed to process claims.
• Identify and report any trends.
• Research and coordinate staff training with Manager to prevent future denials.
• Update PMS system with current insurance fee schedules
• Handles patient inquires and disputes via phone and at the clinic.
• Handles insurance inquiries related to billing via phone.
• Process and post over the phone patient credit card payments.
• Patient collections
• Set up payment arrangements.
• Process and post payments
• Patient refunds
• Identify and research.
• Request and process
• Weekly 1:1 meeting with manager to discuss issues and areas of improvement within the billing department.
• Stay up to date on current CPT and ICD10 billing guidelines.
• Payer Credentialing and re-credentialing for providers

EDCUATION AND EXPERIENCE

• 
  High School graduate or equivalent
• Medical Billing and/or Coding Certification a plus
• Minimum of 1 year Medical Billing experience
• Familiarity with medical and medical billing terminology
• Understanding of basic debits and credits
• Understanding and application of basic Microsoft Excel and Word functions.

QUALIFICATIONS & REQUIREMENTS:

• Strong organizational skills.
• Strong multi-tasking skills.
• Strong verbal and written communication skills.
• Ability to work independently on assigned tasks as well as accept direction on given assignments.
• Ability to work collectively with administration and staff.
• Strong time management skills.