POSITION SUMMARY:
The Medical Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients. The Medical Billing Specialist provides essential support throughout our organization and follows up on submitted claims and patient billing; resubmits claims and/or corrects inaccuracies.
RESPONSIBILITIES:
-
Processes billing to patients and third-party insurance companies
-
Maintains supporting documentation files and current patient addresses
-
Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems
-
Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies
-
Resubmits claims to insurance companies, as necessary
-
Answers questions from patients, clerical staff, and insurance companies
-
Identifies and resolves patient billing complaints
-
Evaluates patient’s financial status and establishes budget payment plans
-
Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
-
Follows up with the provider on any documentation issues
-
Other duties as assigned
EDUCATION/EXPERIENCE/REQUIREMENTS:
-
A high school diploma or GED required
-
Minimum of two (2) years of medical billing experience in a primary care setting required
-
Expert knowledge in health information practices, concepts, and legal requirements required
-
FQHC billing experience preferred
KNOWLEDGE, SKILLS, AND ABILITIES:
-
Excellent customer service skills
-
Ability to establish and maintain effective working relationships with patients, staff, and clinical team
-
Ability to work in a fast-paced office setting
-
Ability to work independently on assigned tasks, as well as to accept direction on given assignments
-
Ability to handle confidential information and/or issues using discretion and judgment
