Full-Time Medical Billing Specialist

Job Summary:

The Medical Billing Specialist is responsible for ensuring that the company receive payment for services rendered to patients. This role involves managing the entire claim process, including coding, claim submission, follow-up on unpaid claims, and resolving billing issues. The specialist will also handle rejections, denials, and appeals to maximize reimbursement. The ideal candidate will have a strong understanding of medical terminology, insurance policies, and billing procedures to optimize revenue while maintaining compliance with regulations.

Key Responsibilities:

Claim Processing:

• Prepare and submit accurate insurance claims for services provided.
• Review and verify patient information and insurance details for accuracy.
• Utilize appropriate coding for procedures and diagnoses (CPT).
• Follow up on unpaid claims and work with insurance companies to resolve payment issues.

Rejections, Denials, and Appeals:

• Analyze rejected or denied claims to identify the reasons for denial.
• Correct and resubmit claims as necessary, ensuring all corrections are accurate and complete.
• Prepare and submit appeals for denied claims, including gathering necessary documentation and following up with insurance companies.
• Track the status of appeals and re-submissions to ensure timely resolution.
• Communicate with insurance companies, patients, and providers to clarify and resolve issues related to rejections, denials, and appeals.

Skills:

• Strong knowledge of CPT and HCPCS coding systems.
• Excellent attention to detail and accuracy in billing/claim processes.
• Strong communication skills, both written and verbal, with the ability to explain claim issues to patients and resolve disputes.
• Ability to work independently and manage time effectively to meet deadlines.
• Knowledge of insurance guidelines, including Medicare, Medicaid, and private carriers.
• Experience in handling claim rejections, denials, and appeals.

Qualifications:

Education:

• High school diploma or GED required.
• Certification in Medical Billing and Coding (e.g., CPC, CCA, or equivalent) is a plus.

Experience:

• Minimum of 2 years of experience in medical billing, preferably within a healthcare setting.
• o Proficiency with billing software (e.g., Simple Practice is a plus) and electronic health records (EHR) systems.

If you have a passion for healthcare administration and possess the required skills, we invite you to apply for this rewarding Medical Billing Specialist position.

Job Types: Full-time, Part-time, Contract

Expected hours: 20 per week

Schedule:

• Monday to Friday

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Remote