Job Summary
We are seeking a detail-oriented and proactive Medical Billing and Authorization Specialist to join our dynamic healthcare team. In this vital role, you will manage the entire revenue cycle process, ensuring accurate billing, timely insurance claim submissions, and efficient authorization procedures. Your expertise will help optimize revenue flow, improve patient satisfaction, and ensure compliance with medical coding guidelines. If you thrive in a fast-paced environment and are passionate about healthcare administration, this is an excellent opportunity to contribute your skills to a dedicated team.
Responsibilities
- Prepare and submit accurate medical claims using billing software, ensuring compliance with ICD-9, ICD-10, CPT coding standards, and DRG (Diagnosis-Related Group) classifications for inpatient services.
- Review and verify medical records and documentation to support billing and coding processes, adhering to medical coding guidelines.
- Obtain prior authorizations from insurance providers by verifying patient coverage, submitting authorization requests, and following up to secure approvals before procedures.
- Manage electronic health record (EHR) systems and EMR (Electronic Medical Record) systems for billing, coding, and record management.
- Process insurance third-party billing claims efficiently while resolving denials through appeals or re-submissions to maximize reimbursement.
- Maintain comprehensive documentation of all billing activities, authorizations, and correspondence related to revenue cycle management.
- Stay updated on health insurance policies, claim processing procedures, and coding changes to ensure ongoing compliance and accuracy.
Qualifications
- Proven experience in medical billing with a strong understanding of health insurance claim processing and revenue cycle management.
- Familiarity with ICD-9/10 coding, CPT coding, DRG classifications, and medical terminology essential for accurate billing.
- Experience working with billing software as well as EMR/EHR systems for electronic health record management.
- Knowledge of medical records management and medical coding guidelines for inpatient and outpatient services.
- Strong understanding of health insurance policies, third-party billing procedures, and insurance claim adjudication processes.
- Excellent attention to detail with the ability to analyze complex medical documentation for accurate coding and billing.
- Effective communication skills for coordinating with providers, insurance companies, and patients.
Join us in delivering exceptional healthcare administration that supports both our patients' well-being and our organization’s success!
Pay: $20.00 - $25.00 per hour
Work Location: In person
