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Now viewing: Medical Billing Specialist
AH
American Heart CenterPC
Medical Billing Specialist
Job Description
Medical Billing SpecialistJob Summary We are seeking an experienced Medical Billing Specialist to join our busy cardiology practice. This role is responsible for the accurate submission, follow-up, and resolution of medical claims to ensure timely reimbursement while maintaining compliance with payer guidelines and HIPAA regulations. The ideal candidate is detail-oriented, organized, and experienced in cardiology billing, insurance claims, and denial management. Responsibilities
- Prepare, review, and submit electronic and paper insurance claims accurately and timely.
- Monitor claim status and resolve claim rejections, denials, and payment discrepancies.
- Verify patient demographics, insurance eligibility, and billing information.
- Review medical documentation and coding to ensure accurate claim submission.
- Work directly with insurance companies to resolve billing issues and maximize reimbursement.
- Process claim corrections, appeals, and resubmissions as needed.
- Maintain accurate billing records and documentation within the electronic health record (EHR) and practice management system.
- Reconcile charges, payments, and explanations of benefits (EOBs).
- Ensure compliance with Medicare, Medicaid, commercial payer guidelines, and HIPAA regulations.
- Collaborate with providers and staff to resolve billing questions and improve revenue cycle performance.
- Participate in ongoing training and perform additional duties as assigned. Qualifications
- High school diploma or equivalent required.
- CPC, CCS, or equivalent coding certification preferred.
- Minimum 3-5 years of medical billing experience ; cardiology billing experience strongly preferred.
- Working knowledge of ICD-10-CM, CPT, HCPCS, and
CMS-1500
claim processing.- Experience with EHR/practice management software (Allscripts experience preferred).
- Strong understanding of insurance plans, prior authorizations, claim appeals, and denial management.
- Proficient in Microsoft Office, including Excel and Outlook.
- Excellent communication, organizational, and problem-solving skills.
- Ability to work independently while managing multiple priorities in a fast-paced environment.