Medical Biller

About Job Role:

The Medical Billing Specialist will be responsible for managing various aspects of the medical billing process, ensuring accurate and timely processing of claims and payments within the revenue cycle. Key responsibilities include:

• Charge Entry and Payment Posting: Process charge entries and payment posting transactions using the revenue cycle software provided by the client.
• Claims Preparation and Submission: Prepare and submit accurate medical claims to insurance companies, ensuring compliance with all relevant regulations.
• Patient Information Verification: Verify patient demographic information and insurance details for each claim to ensure accuracy and completeness.
• Regulatory Compliance: Ensure compliance with coding and billing regulations, maintaining up-to-date knowledge of industry standards.
• Medical Coding: Assign appropriate medical codes to diagnoses and procedures, ensuring correct coding practices are followed.
• Documentation Review: Review medical records to ensure proper documentation is available for billing purposes.
• Industry Updates: Stay informed about coding changes and updates in industry regulations that may impact billing practices.
• Insurance Verification: Verify patients' insurance coverage and eligibility to facilitate accurate claims processing.
• Issue Resolution with Insurers: Communicate with insurance companies to resolve issues related to claim denials or delays effectively.
• Inquiry Response: Respond promptly to inquiries from patients, insurance companies, and internal staff regarding billing issues, providing clear and accurate information.
• Discrepancy Resolution: Address and resolve billing discrepancies and disputes in a timely manner to maintain positive relationships with clients and insurers.
• Payment Posting: Post payments received from insurance companies and patients accurately into the billing system.
• Account Reconciliation: Reconcile accounts, identifying and resolving payment discrepancies as they arise.
• Reporting and Analysis: Generate and analyze reports related to billing and reimbursement processes, providing insights into performance metrics.
• Claim Status Updates: Provide regular updates on the status of outstanding claims to management and relevant stakeholders.
• This role requires a detail-oriented professional with strong analytical skills who is committed to ensuring accuracy in the medical billing process while delivering excellent service to patients and healthcare providers.

Qualifications:

• Educational Background: A Bachelor's degree in any discipline or equivalent work experience is required.
• Medical Billing Expertise: Strong understanding of medical billing processes, coding systems, and applicable regulations.
• Professional Experience: Minimum of 6+ month of proven experience in medical billing is essential.
• Communication Skills: Excellent communication and interpersonal skills, with the ability to effectively interact with patients, insurance representatives, and internal stakeholders.