SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions.
SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions. ** Hand on experience in ECW software preferrable**
A patient calling role in medical billing primarily involves handling communication with patients regarding their medical bills and payments. This includes tasks like making outbound calls to patients to discuss outstanding balances, setting up payment plans, and addressing billing inquiries. They also may need to verify insurance coverage, update patient information, and collaborate with healthcare providers on billing discrepancies. Here's a more detailed breakdown of the responsibilities: Core Responsibilities: Outbound Calling: Making calls to patients to follow up on unpaid bills or to discuss billing issues. Payment Processing: Accepting payments, setting up payment plans, and handling financial transactions. Insurance Verification: Confirming patient insurance coverage and eligibility. Billing Inquiries: Addressing patient questions and concerns regarding their bills. Data Management: Updating patient information and billing records in the system. Collaboration: Working with other departments, like medical coding and insurance claims processing, to resolve billing issues. Documentation: Maintaining accurate records of all patient interactions and transactions. Key Skills: Communication: Excellent verbal and written communication skills are essential for explaining complex billing information to patients. Customer Service: The ability to handle patient inquiries with empathy and professionalism. Problem-Solving: Identifying and resolving billing discrepancies and payment issues. Organization: Managing multiple patient accounts and tasks effectively. Computer Literacy: Proficiency in using medical billing software and navigating online portals. Medical Terminology: Basic understanding of medical terms and procedures to understand billing details.
SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions.
We are seeking an experienced Medical Coder with a strong background in Cardiology coding to join our growing team. The ideal candidate will possess deep knowledge of cardiovascular procedures and diagnostic codes, ensuring accurate and compliant coding to optimize reimbursement and maintain regulatory standards. Key Responsibilities: Accurately assign ICD-10-CM, CPT, and HCPCS Level II codes for cardiology-related procedures and diagnoses. Review and analyze medical documentation provided by physicians to ensure coding reflects the services rendered. Stay updated with changes in coding guidelines and payer-specific requirements related to cardiology. Collaborate with physicians and clinical staff to clarify documentation and resolve coding discrepancies. Maintain productivity and accuracy benchmarks as set by the organization. Assist in audits and quality assurance efforts to ensure compliance with federal, state, and payer regulations. Requirements: High school diploma or equivalent required; Associates or Bachelor’s degree in Health Information Management or related field preferred. Certification required: CPC , CCS , or CRC (AHIMA or AAPC). Minimum 2 years of experience in cardiology coding. In-depth understanding of cardiovascular procedures such as catheterizations, pacemaker insertions, electrophysiology studies, echocardiograms, and stress tests. Strong knowledge of medical terminology, anatomy, and physiology related to the cardiovascular system. Proficient with EHR systems and coding software (e.g., EPIC, 3M, EncoderPro, etc.). Excellent attention to detail and strong analytical skills. Preferred Qualifications: Experience with interventional cardiology or electrophysiology coding. Knowledge of billing compliance and payer-specific guidelines. Prior experience working in a cardiology clinic, hospital, or specialty practice.
Job description CREDENSE MB is looking for multiple candidates with good analytical skills with understanding of US Health care. Candidate should have knowledge on Complete Revenue Cycle Management Accounts Receivables Medical Billing **MUST HAVE EXCELLENT COMMUNICATION SKILLS IN ENGLISH ** **MUST BE GOOD IN MS OFFICE TOOLS****NEED TO WORK IN SHIFTS ** Job Description: US Healthcare Charge Entry Payment posting Accounts Receivables Calls Denials and Appeals Management End to End Billing Cycle Management Posting Payments Eligibility Verification Prior Authorization Knowledge of Insurance Eligibility verification Good understanding of medical terminology, disease processes Excellent Communication Skills Willingness to work late/night shift/US Timings Initiate calls to insurance companies for claim resolution and follow-up. Address patient inquiries regarding billing issues and provide clear explanations. Collaborate with internal teams to resolve discrepancies and expedite claims processing. Maintain detailed records of interactions and claim statuses for accurate reporting. Adhere to industry regulations and compliance standards in all communication and documentation. Experience in healthcare revenue cycle management or a related field. Experience in working on different billing softwares like EPIC, NextGen, Tebra, ECW Understanding of medical billing codes, insurance processes, and claim adjudication. Strong communication skills for effective interaction with insurance companies and patients. Attention to detail and accuracy in navigating complex billing and coding systems. Adaptability to evolving industry regulations and technological advancements. This job requires the ability to work with others in a team environment, the ability to accept direction from superiors and the ability to follow Company policies and procedures. Regular, predictable and dependable attendance is essential to the satisfactory performance of this job.
Responsibilities: Regulatory compliance: Ensure that the department complies with industry standards and government regulations Patient and Insurance payments: Follow up with patients who have not paid their bills Financial responsibility: Confirm who is financially responsible for a particular visit Communication: Ensure that all departments communicate effectively Problem-solving: Resolve disputes between staff and balance budgets Interpersonal skills: Use empathy and leadership to manage staff and departments Strategic planning: Implement policies and procedures to improve operations
1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions.