Medical Billing Specialist

Responsibilities:

Utilizes various hospital/physician systems to verify patient, billing and claim information for accuracy.
Performs compliant primary/secondary, tertiary and re-bill billing functions, including electronic, paper and portal submission to government and/or commercial payers.
Edits claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
Responds timely to emails and telephone messages, as appropriate.
Communicates issues to management, including payer, system or escalated account issues.
Participates and attends meetings and training seminars, as requested.
Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.
Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
Updates patient demographics/insurance information in appropriate systems.
Monitors claims for missing information, authorization and control numbers (ICN//DCN).
Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.
Secures needed medical documentation required or requested by third party insurance carriers.
Maintains and respects the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.

Minimum Requirements:

2+ years of medical collections/billing experience
Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
Intermediate knowledge of third party billing guidelines
Intermediate knowledge of billing claim forms (UB04/1500)
Intermediate knowledge of payor contracts
Working knowledge of Microsoft Word and Excel
Intermediate working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)

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