Medical Billing Specialist

POSITION SUMMARY:

The Medical Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients. The Medical Billing Specialist provides essential support throughout our organization and follows up on submitted claims and patient billing; resubmits claims and/or corrects inaccuracies.

RESPONSIBILITIES:

• Processes billing to patients and third-party insurance companies
• Maintains supporting documentation files and current patient addresses
• Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems
• Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies
• Resubmits claims to insurance companies, as necessary
• Answers questions from patients, clerical staff, and insurance companies
• Identifies and resolves patient billing complaints
• Evaluates patient’s financial status and establishes budget payment plans
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
• Follows up with the provider on any documentation issues
• Other duties as assigned

EDUCATION/EXPERIENCE/REQUIREMENTS:

• A high school diploma or GED required
• Minimum of two (2) years of medical billing experience in a primary care setting required
• Expert knowledge in health information practices, concepts, and legal requirements required
• FQHC billing experience preferred

KNOWLEDGE, SKILLS, AND ABILITIES:

• Excellent customer service skills
• Ability to establish and maintain effective working relationships with patients, staff, and clinical team
• Ability to work in a fast-paced office setting
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments
• Ability to handle confidential information and/or issues using discretion and judgment