Medical Billing Specialist - Remote | WFH

Medical Billing Specialist

Are you detail-oriented and passionate about ensuring accurate and timely billing for medical services? Join our team as a Medical Billing Specialist, where you'll play a crucial role in the efficient submission and management of insurance claims. We're looking for a dedicated professional to collaborate with patients, clinical staff, and insurance providers to... streamline our billing processes and reduce denied claims.

Key Responsibilities

Patient Information Management: Review and confirm patient demographic and insurance information, ensuring all details are accurate for the services provided.

Documentation Coordination: Obtain necessary medical documentation from clinicians to submit to insurance companies for review and prior authorization of treatments. Document authorization reference numbers in the EMR and other systems.

Claims Preparation: Update and maintain EMR and other systems based on provided documentation to create medical claims or post self-pay charges. Prepare electronic claim files for submission.

Claim Monitoring: Monitor accepted and denied claims, making necessary updates for resubmission.

Billing Reconciliation: Compare transaction reports with daily schedules to ensure all services are billed timely each month.

Credit and Collections: Resolve credit balances and prepare statements for outstanding patient balances.

Daily Charge Capture: Perform daily charge capture functions, including data entry of charges into the EMR platform, ensuring reconciliation with the schedule for all patients seen daily.

Accuracy Assurance: Ensure the appropriateness of charges based on services rendered. Work with Clinic leadership, RCM Leadership, and the Coding Team to maintain accuracy.

Additional Responsibilities: Further details will be provided during the interview process.

Qualifications

Education: High School Diploma or equivalent required; Associate's degree preferred.

Experience

1-2 years of medical billing experience in a women's clinic or physician practice setting required.

Experience in medical billing related to a lab and ASC setting is preferred.

Skills And Knowledge

Proficient in CPT code sets and requirements, including modifiers, CPT bundling/unbundling, diagnosis assignment, Evaluation and Management Codes, Lab Codes, and ASC HCPC code sets.

Familiarity with claim edits and clearinghouse functionality.

Experience with medical billing platforms used in clinic and physician practice settings.

What We Offer

Comprehensive Benefits: Health, vision, and dental packages, including HSA/FSA, Life, and Disability Insurance.

Generous PTO: 18 days of accrued PTO in addition to 11 paid holidays.

Fertility Benefits

401(k) Plan: Retirement plan with a generous company match.

Collaborative Environment: Team-oriented, supportive work environment with opportunities for internal growth.

Employee Assistance Program

Continuing Education: Reimbursement for ongoing professional development.

Employment Type: Full-Time

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