Medical Billing Specialist

POSITION SUMMARY:

The Medical Billing Specialist (MBS) is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. This individual will prepare and submit clean claims to Medicare, various commercial insurance carriers, and Self-Pay patients. The MBS will contact payers regarding unpaid claims and research and/or ensure that questions and requests for information are addressed in a timely and professional manner to ensure resolution and reimbursement. The MBS will ensure timely, effective, and thorough management of claims to ensure full, expected reimbursement for services provided and will prioritize claims based on aging and outstanding dollar amounts or as directed by management. The MBS provides essential support throughout our organization and follows up on submitted claims and patient billing; resubmits claims and/or corrects inaccuracies.  

RESPONSIBILITIES:

• Processes billing to patients and third-party insurance companies
• Maintains supporting documentation files and current patient addresses
• Researches and responds by telephone and/or in writing to patient inquiries regarding billing issues and problems
• Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies
• Resubmits claims to insurance companies, as necessary
• Answers questions from patients, clerical staff, and insurance companies
• Identifies and resolves patient billing complaints
• Evaluates patient’s financial status when a payment plan is requested
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers, and submitting to our outside collection agency if necessary
• Follows up with the provider and/or medical staff on any documentation issues
• Any other duties as requested

EDUCATION/EXPERIENCE/REQUIREMENTS:

• A high school diploma or GED required
• Minimum of one (1) year of medical billing experience in a primary care setting required
• Excellent computer skills required
• Expert knowledge in health information practices, concepts, and legal requirements required
• Extensive knowledge of medical terminology strongly recommended
• Previous experience with Aprima software program preferred but not required
• FQHC billing experience preferred

KNOWLEDGE, SKILLS, AND ABILITIES:

• Excellent customer service skills
• Ability to establish and maintain effective working relationships with patients, staff, and clinical team
• Ability to work in a fast-paced office setting
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments
• Ability to handle confidential information and/or issues using discretion and judgment

Offers an excellent benefits package to include: health insurance, long term disability, AFLAC products (Dental, Accident, Vision, and Short-Term Disability), 401K plan with match, paid holidays, vacation, and sick time

Salary:

Competitive based on experience