Medical Billing Specialist

Robert Half is looking for a Medical Biller to play a crucial role in a local office by ensuring accurate and timely billing and reimbursement for medical services provided to patients. They will be responsible for processing medical claims, verifying insurance coverage, and maintaining detailed records of billing and payment transactions. This role requires strong attention to detail, knowledge of medical coding and insurance regulations, and effective communication skills.

Key Responsibilities:

• Gather and review patient medical records, treatment notes, and invoices.
• Assign appropriate medical codes (e.g., CPT, ICD-10) to services rendered.
• Ensure the accuracy and completeness of claim information.
• Verify patient insurance coverage and eligibility for services.
• Confirm the patient's responsibility for copayments, deductibles, and co-insurance.
• Submit pre-authorization requests when necessary.
• Electronically or manually submit insurance claims to payers.
• Ensure claims are submitted within specified timelines to expedite reimbursement.
• Monitor and track the status of claims.
• Investigate and resolve claim denials or rejections promptly.
• Appeal denied claims when appropriate, providing necessary documentation.
• Work with insurance companies to resolve claim disputes.
• Generate patient statements for outstanding balances.
• Assist patients with questions regarding their bills and payment options.
• Establish payment plans or negotiate settlements for patients in financial need.
• Stay current with healthcare regulations, coding updates, and billing guidelines.
• Ensure compliance with HIPAA regulations to protect patient confidentiality.
• Maintain accurate and organized billing records and electronic databases.
• Document all communication and actions taken related to billing and claims.
• Prepare and present reports on billing and collection activities to management.
• Identify trends and areas for process improvement.
• Provide excellent customer service to patients, insurance companies, and healthcare providers.
• Address inquiries and concerns professionally and promptly.
• Stay informed about changes in medical billing practices and technology.

Salary : $23 - $26