Medical Billing Specialist 22O25

The Medical Billing Specialist plays a vital role in the healthcare industry by managing billing processes for healthcare providers. This position involves working closely with healthcare facilities, insurance companies, and patients to ensure the accurate and timely submission of medical claims. The specialist must be well-versed in medical coding, insurance guidelines, and billing procedures. This role is crucial for securing the financial health of medical practices by ensuring that they receive full payment for their services. An ideal candidate for this position will possess a keen eye for detail, excellent organizational skills, and the ability to communicate effectively with various stakeholders in the healthcare system. The Medical Billing Specialist must stay updated with industry changes and collaborate with other team members to streamline processes and improve efficiency in billing operations.

Responsibilities

• Prepare and submit accurate claims to insurance companies and other payers.
• Review and ensure the accuracy and completeness of all billing documentation.
• Follow up on unpaid claims to ensure timely resolution of billing discrepancies.
• Verify patients' insurance coverage and gather necessary pre-authorization details.
• Coordinate with healthcare providers for correcting claim information as needed.
• Maintain current knowledge of billing regulations, insurance policies, and compliance guidelines.
• Respond to patient inquiries regarding billing issues, adjustments, and payment plans.
• Generate billing reports and analyze data to improve claim success rates.
• Collaborate with the accounting department for reconciling payments and accounts.
• Provide training and guidance to junior billing staff if required by the management.
• Assist in the development and updating of billing procedures and policies.
• Secure patient information by completing data backup procedures and maintaining confidentiality.

Requirements

• High school diploma or equivalent; certification in medical billing is preferred.
• Minimum of two years of experience in medical billing or related field.
• Proficiency in medical coding (CPT, ICD-10, and HCPCS) regulations and guidelines.
• Strong knowledge of insurance processes, billing practices, and claims resolution.
• Exceptional attention to detail with strong quantitative and analytical skills.
• Excellent communication and interpersonal skills to work with diverse teams.
• Ability to handle sensitive information with the highest degree of integrity and confidentiality.