Medical Billing Specialist

Position Status: Full-Time

Supervisor: Billing Manager

Medical billing specialists are responsible for managing the flow of money into and out of an organization

Duties:

A medical billing specialist typically has a wide range of responsibilities, which can include but not limited to:

• Speaking with patients to collect payments for services rendered, negotiating payment plans with them, and following up on delinquent accounts
• Develop and maintain a comprehensive understanding of the revenue cycle process.
• Timely follow-up and resolution on all A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.
• Manage daily work queue to prioritize high dollar claim balances.
• Review and work incoming insurance and patient correspondence including refund request.
• Working with insurance companies to determine coverage for medical procedures or treatments
• Consulting with hospital administrators regarding changes in regulations that may affect billing practices
• Reviewing claims to ensure that they are correctly coded according to industry standards
• Communicating with physicians’ offices to obtain clinical documentation needed to support claims
• Reviewing patient records to identify insurance coverage or possible treatment complications that could affect claims processing
• Reporting claims status to clients on a regular basis to ensure accurate communication between departments within a healthcare organization
• Requires predictable and consistent attendance 

What You’ll Need:

• Must have a High School Diploma or equivalent.
• 2-4 years of experience in the field or in a related area. Relies on experience and judgment to plan and accomplish goals. Familiar with standard concepts, practices, and procedures within realm of responsibility.
• Ability to read and interpret insurance explanation of benefits and managed care contracts.
• Must communicate effectively, both verbally and in writing, with internal and external clients
• Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines

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