Medical Billing Specialist
hace 4 días
Job Summary
The Medical Billing Specialist is responsible for preparing, submitting, and processing billing for medical services rendered within the facility. The role works closely with healthcare providers, insurance companies, and patients to ensure accurate claim submissions and timely pay
Job Description
• Prepare and submit claims for facility services using appropriate coding systems (ICD-10, CPT, HCPCS). Ensure claims are accurate and compliant with payer requirements.
• Monitor and follow up on outstanding claims, resolve denials or rejections, and ensure timely payment. Investigate and address any discrepancies or issues with claims.
• Verify patient insurance coverage and eligibility for facility services. Ensure accurate documentation of benefits and coverage details.
• Adhere to healthcare regulations, including HIPAA and payer-specific guidelines. Ensure all billing practices are compliant with federal, state, and payer policies.
• Address patient inquiries related to billing, provide explanations of charges, and assist with payment arrangements as needed.
• Generate and review billing reports to track revenue cycle performance, identify trends, and suggest improvements. Maintain accurate and organized billing records.
• Collaborate with the billing team, healthcare providers, and administrative staff to resolve billing issues and enhance the billing process.
• Stay updated on changes in billing regulations, coding practices, and payer policies. Implement best practices to improve billing efficiency and accuracy.
Required Qualifications
• Experience using any facility billing software and electronic health record (EHR) systems.
• Experience using Microsoft Office Suite (Word, Excel, Outlook) and billing submission systems.
• Maintain confidentiality and ensure compliance with HIPAA and payer regulations.
• Has background in facility billing procedures and healthcare coding.
• Demonstrates strong attention to detail to ensure accurate billing and timely claim submission.
• Demonstrates analytical and problem-solving skills to identify billing discrepancies and implement corrective actions.
• Clear and coherent both written and verbal communication skills in English for coordinating with providers and patients.
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