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Medical Billing Specialist
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Primary Care of Southwest Georgia
Thomasville, GA (In Person)
$38,480 Salary, Full-Time
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Job Description
The Medical Billing Specialist is a medical professional responsible for managing the administrative responsibilities of billing insurance and processing payments for patients. Using the electronic medical records (EMR) system, the Medical Billing and Collection Specialist will perform multiple duties including filing health insurance claims with various insurance companies and following up with insurance companies on payments of claims. This position will involve recording payments to patient accounts when payments are received. Most of the task for this position will involve using the EMR and training on the system will be structured and conducted by current employees and a consulting firm. The successful candidate will have medical terminology knowledge and have demonstrated ability to learn how to use the EMR system. The organization is willing to work with applicants currently enrolled in medical billing and coding classes. Job Description This position is involved in entire revenue cycle. Responsible for billing of all payers, filing claims, working denials, review of accounts receivable, running and reviewing pending claims, working with Billing Manager to maintain targeted financial goals. This individual will assist staff with proper coding, stay abreast of coding and payer changes, and provides educational assistance to providers. Employee will follow all PCSWGA financial policies and procedures. Roles & Responsibilities Process EOBs, correct claims, and resubmit claims Files secondary insurance claims Follows up on all insurance accounts receivable Assists in maintaining accounts receivable at targeted goals. Stays abreast of coding and payer changes by attending workshops and audio conferences. Identifies write-offs, refunds and adjustments to Billing Manager. Trouble shoots with IT and Billing Manager all system problems that create claim problems. Posts payments to A/R and processes turnaround documents for follow up on payment claims. Electronic transmission of claims daily and reviews/corrects all edits/rejects. Assists patients and staff with billing and insurance questions. Reviews all claims for correct ICD 10 codes, CPT codes, modifiers and sliding fee adjustments. Performs other duties as assigned by Billing Manager. Qualifications & Education Requirements High school diploma or equivalent. Prior medical billing experience essential. Coding certification highly desirable. Knowledge, Skills, & Abilities Prior experience with medical practice computer billing system. Extensive computer experience including the ability to verify insurance coverage. Has performed claims transmission, payment posting, and insurance adjustments. Ability to determine if payment denial is appropriate. Knowledge of current