Role Overview:
- We are looking for a full-time, highly detailed, accurate, and motivated Medical Billing Specialist to help the company in our claims resolution department.
- The main focus is on resolving outstanding insurance claims to ensure maximum payer reimbursement for clients.
- The ideal candidate is extremely organized, highly attentive to detail, professional, takes initiative, and values the importance of efficiencies.
- The candidate should be comfortable with technology systems and needs to be able to speak, read, write, and understand American English.
Required Skills and Duties:
- Experience in office practices and procedures in U.S. Healthcare.
- Proficiency in computer use and data entry.
- Experience with word processing and spreadsheet applications.
- Minimum of 40wpm typing speed.
- 10-key by touch.
- Ability to work well with people.
- Maintain confidentiality.
- Communicate effectively.
- Experience in CPT, ICD-10, and Medical Terminology.
- Familiarity with EOBs, data entry, and working with insurance companies.
- Critical thinking skills, including utilizing available resources, seeking answers prior to asking for assistance, analyzing situations, and making decisions.
- Knowledge of Microsoft products, Google Platform, and Medical Billing software.
- Experience with EHRs is a plus.
- Ability to prioritize multiple tasks, projects, and demands successfully.
- Ability to work independently, research and resolve issues, and answer questions using tools provided.
- Close attention to detail, high accuracy, and stellar organizational skills.
- Desire to be part of a performance-driven team taking responsibility for obtaining goals as set by management.
- Maintain extreme confidentiality at all times regarding patient, client, and colleague information.
- Excellent customer service skills.
- Strong written and verbal communication skills.
- Ability to work well within a team as well as individually.
- Responsible use of confidential information.
- Perform to company standards of compliance with policies and procedures.
- Experience researching and relaying knowledge effectively is a plus.
Functions and Duties:
- Take appropriate follow-up action on underpaid, no response, and denied claims.
- Review account registration, charge entry, coding, payments, and contractual adjustments posted.
- Review account and claim history following steps to swiftly and efficiently resolve.
- Research and effectively communicate payer trends and issues.
- Research and resolve payer rejects and denials with a goal to prevent them in the future.
- Document actions in an accurate and concise manner.
- Communicate effectively and professionally with insurance representatives, internal team members, and providers.
- Identify, research, and resolve credit balances.
- Perform other duties as assigned.
Required Experience:
- Education: High school diploma or GED equivalent. College degree preferred.
- Experience: Two years in revenue cycle and insurance resolution (claims follow-up) highly preferred.
