POSITION: Medical Billing Specialist
REPORTS TO: Office Manager
EDUCATION AND EXPERIENCE:
- High School Diploma
- 1+ Years in Medical Billing
- Customer Service Experience
- Training and Experience in ICD-10 preferred
- CPC or equivalent coding certification preferred
GENERAL PURPOSE: To support the daily operations and functions of the practice. With the purpose and responsibility to support and secure the financial position of the company through the accurate and timely billing of claims.
JOB REQUIREMENTS AND TASKS:
- Review and validate billing codes within patient charts based on diagnosis and procedures
- Work with medical providers to continuously ensure proper patient charges are recorded. Ensure charges are dropped for providers in the electronic medical record
- Enter and verify patient’s insurance, and Medicare or Medicaid eligibility
- Work with insurance companies to resolve issues and counsel patients on fees and charges. Collect and receive payments and apply them to the patient accounts
- Track and report collection and billing information daily
- Responsible for preparing data for medical billing processing by applying diagnostic (ICD-10) codes to billing reports, reviewing CPT procedures and site documentation for completeness
- Additional responsibilities include making follow up phone calls to the insurance companies on all denied and/or re-billed claims to ensure that payment is received
- Also you must be able to develop and run billing reports to give updates to management on each claim and where in the process each reimbursement is at
- Apply ICD-10 diagnostic codes to billing reports
- Review CPT procedures codes for accuracy and compliance
- Review denials and recode when needed.
- Contact insurance companies for verifications, clarifications on denials, etc
- Review Medicare bulletins to stay up to date industry and any changes to the billing process
- Adhere to all HIPAA regulatory requirements
- Follow up with insurance companies on outstanding A/R
- Send appeals for claims as needed
- Send claims to insurance for reimbursement.
- Call Medicare for reopening’s and redeterminations and track them in reopening log
- Answer phones/assist front office
- Post checks and charges when needed
KEY COMPENTENCIES & SKILLS:
- Have a strong knowledge of services offered by all of our providers for both cosmetic and medical
- Have a strong knowledge of medical terminology, procedures, codes, and products
- Exceptional customer service and phone etiquette
- Strong Knowledge of insurance companies, Medicare, and Medicaid.
- Must have knowledge of state and federal laws regarding patient medical records privacy and confidentiality including Federal HIPAA Privacy and Security Rules.
- Ability to work at all Contour Dermatology and Cosmetic Surgery Center locations
- Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
- Moving about on foot to accomplish tasks (i.e. – going into patient rooms).
- Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers.
- Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.
- Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
- The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects, small parts, and/or operation of machines (including inspection); using measurement devices; and/or assembly or fabrication parts at distances close to the eyes.