As a professional in the Accounts Receivable or Medical Billing field, your primary responsibilities will include initiating calls to insurance companies and patients to follow up on outstanding claims and invoices. You will be required to verify insurance coverage and obtain authorization for pending claims, as well as review and analyze denials to determine the appropriate actions for appeal. It will be crucial to document all communication and actions taken on accounts, resolve billing discrepancies, and address customer inquiries related to accounts. In cases of complex issues, escalation to management for resolution will be necessary. In this role, you must adhere strictly to all regulatory compliance and company policies while meeting daily and monthly targets for productivity and collections. Collaboration with internal teams such as billing, coding, and customer service will be essential to streamline processes effectively. Identifying trends and patterns in denials or rejections and proposing process improvements will also be part of your responsibilities. Additionally, participation in regular training and knowledge-sharing sessions, contribution to the development and maintenance of best practices, and providing support during audits and process reviews will be expected. It is imperative to stay updated with changes in billing regulations and coding guidelines, and assist in special projects or ad hoc tasks as necessary. To be successful in this role, you must possess a Bachelor's degree in Healthcare Administration, Business, or a related field, along with a minimum of 2 years of experience in accounts receivable or medical billing. A strong understanding of medical terminology, CPT and ICD-10 coding, proficiency in using billing systems and electronic health records (EHR), and excellent communication and negotiation skills are essential. Analytical skills to identify trends for process improvements, detail-oriented accuracy in documentation and record-keeping, and a proven track record of meeting collection targets are required qualifications. Furthermore, knowledge of insurance verification and authorization processes, ability to work both independently and as part of a team in a fast-paced environment, familiarity with regulatory compliance and industry standards such as HIPAA, strong problem-solving skills, and adaptability to technological and industry practice changes are crucial. Certification in medical coding or billing (e.g., CPC, CPB) and experience with voice-based communication in a call center or similar setting will be advantageous skills in this role.,
As a Medical Billing Specialist, you will be responsible for initiating calls to insurance companies and patients to follow up on outstanding claims and invoices. Your duties will include verifying insurance coverage, obtaining authorization for pending claims, and reviewing denials to determine appropriate actions for appeal. It will be crucial for you to document all communication and actions taken on accounts, resolve billing discrepancies, and address any customer inquiries related to accounts. In case of complex issues, you will escalate them to management for resolution. Adhering to all regulatory compliance and company policies will be a key part of your role. Meeting daily and monthly targets for productivity and collections will also be essential. Collaboration with internal teams such as billing, coding, and customer service to streamline processes is expected. You will be required to identify trends and patterns in denials or rejections and propose process improvements accordingly. Your responsibilities will also include participating in regular training and knowledge sharing sessions, contributing to the development and maintenance of best practices, and providing support during audits and process reviews. Staying updated with changes in billing regulations and coding guidelines is crucial. Additionally, you may be involved in special projects or ad hoc tasks as necessary. To qualify for this role, you must hold a Bachelor's degree in Healthcare Administration, Business, or a related field. A minimum of 2 years of experience in accounts receivable or medical billing is required. Strong understanding of medical terminology, CPT and ICD-10 coding, proficiency in using billing systems and electronic health records (EHR), and excellent communication and negotiation skills are essential. Analytical skills to identify trends, detail-oriented nature for accurate documentation, and proven track record of meeting collection targets are necessary. Knowledge of insurance verification and authorization processes, ability to work independently and as part of a team in a fast-paced environment, familiarity with regulatory compliance and industry standards such as HIPAA, and strong problem-solving skills are desired qualities. Certification in medical coding or billing (e.g., CPC, CPB) would be a plus. Experience with voice-based communication in a call center or similar setting is advantageous. In summary, this role requires a combination of technical knowledge, communication skills, attention to detail, and the ability to adapt to changes in technology and industry practices. If you are looking for a challenging yet rewarding position in the healthcare industry, this role could be a great fit for you.,