Job Summary:

A Medical Billing Specialist is responsible for managing the billing process for healthcare providers. They ensure accurate coding, billing, and timely submission of claims to insurance companies, government agencies, and patients. Their duties include reviewing patient records, ensuring compliance with insurance policies and regulations, resolving billing discrepancies, and following up on unpaid claims. The goal is to maximize reimbursement for services provided while maintaining accurate financial records and adhering to healthcare regulations. They may also be involved in handling patient inquiries regarding their bills and processing payments.

Key Responsibilities:

Review and verify patient insurance information. Code medical procedures and diagnoses accurately. Submit claims to insurance companies and government agencies. Follow up on unpaid or denied claims and resolve billing issues in a timely manner. Communicate with healthcare providers, insurance companies, and patients regarding billing concerns. Ensure compliance with federal, state, and insurance regulations. Maintain patient confidentiality and adhere to HIPAA standards. Generate and send patient invoices for outstanding balances, ensuring clarity and accuracy. Answer patient billing inquiries, explain charges, and help with payment arrangements. Post payments received from insurance companies and patients into the billing system. Reconcile payment discrepancies and ensure the correct amount is applied to patient accounts. Review patient and insurance overpayments and assign a refund as needed. Provide Clinic with Patient balances. In addition to the core responsibilities of a Medical Billing Specialist, there may be other tasks assigned by the manager to ensure smooth operations and maintain efficiency within the department.

Skills & Qualifications:

Knowledge of medical terminology, coding systems (e.g., ICD-10, CPT). Familiarity with healthcare billing software and electronic health records (EHR). Strong attention to detail and organizational skills. Effective communication and problem-solving abilities. Understanding of insurance policies and regulations.

Education:

High school diploma or equivalent (required). Certification in medical billing or coding (preferred) The role is crucial in maintaining the financial health of a healthcare facility and ensuring smooth financial transactions between patients, healthcare providers, and insurance companies.

Job Type:

Full-time Experience:

Medical billing: 1 year (Required)

Work Location:

In person