Billing, Claims Processing, Communication Skills, Corporate Policies, Current Procedural Terminology (CPT), Customer Support/Service, Detail Oriented, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Healthcare Administration, High School Diploma, ICD-10, Insurance, Insurance Claims, Maintain Compliance, Medical Billing, Medical Coding, Medical Record System, Medical Terminology, Medical Treatment, Multitasking, Regulations, Telephone Skills
The Medical Billing Specialist is responsible for accurately processing and submitting medical claims to insurance companies. This role ensures that all billing activities are completed in compliance with payer guidelines and company policies to optimize revenue and maintain patient satisfaction.
Key Responsibilities
- Prepare, review, and submit medical claims to insurance companies electronically or by paper.
- Verify patient insurance coverage and obtain necessary authorizations or referrals.
- Review patient accounts for accuracy and completeness prior to billing.
- Respond to patient and insurance inquiries regarding billing and account status.
- Answer phones and take patient payments.
- Collaborate with RCM Leads, coders, and other staff to ensure accurate billing.
- Stay current with work queue assignments.
- Ensure compliance with HIPAA, payer regulations, and internal policies.
Education & Experience
- High school diploma or equivalent required; associate degree in medical billing or healthcare administration preferred.
- Minimum 1-2 years of experience in medical billing or healthcare revenue cycle preferred.
Skills & Competencies
- Knowledge of insurance billing procedures, medical terminology, and CPT/ICD-10 coding.
- Familiarity with EHR and billing systems.
- Strong attention to detail and accuracy.
- Excellent communication and customer service skills.
- Ability to work independently and handle multiple tasks in a fast-paced environment.