Medical Billing/Insurance Specialist

General Job Summary Responsible for physician/provider billing, posting of insurance payments, and follow up of claim denials. This position also assists with collecting on patient accounts. Adheres to Burke Primary Care policies and procedures to ensure the delivery of high quality patient care.

Education/Professional Experience/Skills Required:

High school diploma or equivalent Prior medical office experience preferred Knowledge of CPT, ICD-10 and HCPCS Coding required Knowledge of Medicare, Medicaid and other payer requirements Work Environment Medical office environment, minimal risk of exposure to potentially infectious diseases associated with healthcare setting.

Essential Job Responsibilities General:

• Responsible for ensuring charges are entered correctly on a daily basis including diagnosis, procedures and modifiers
• Responsible for posting payments and adjustments to appropriate accounts
• Responsible for maintaining information on managed care contracts, keeping current on requirements and changes and ensures reimbursement is followed per agreement with each individual plan
• Responsible for maintaining sufficient knowledge of Medicare, Medicaid and other federal and state health care program requirements necessary for accurate claims submission
• Responsible for electronic and paper claims filing
• Responsible for balancing of charges and revenue posting
• Responsible for ensuring that appropriate documentation is obtained and submitted with claims as necessary
• Responsible for following up on accounts receivables through EOB analysis, payer communication and practice staff communication as directed by supervisor
• Responsible for establishing an audit trail of claims not paid and working to secure reimbursement on individual claims per policy
• Communicates with payers in a timely manner on all inquiries and requests for information
• Ensures accurate data entry with regards to claims submission
• Provides assistance to patient inquiries regarding accounts
• Responsible for release of medical information limited solely to that information necessary for claims payment
• Performs other tasks as assigned by supervisor

Job Type:

Full-time Benefits:

401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance

Experience:

Medical Billing and Coding:

1 year (Preferred) Ability to

Commute:

Morganton, NC 28655 (Required)

Work Location:

In person