Position Summary
We are seeking a Medical Billing & Back Office Specialist who lives their core values of being caring, knowledgeable, and exceptional with a passion for serving our patients. This leader will exude positivity and demonstrate operational excellence, ownership of their business, and the expertise to act with a sense of urgency. Our team members deliver an impeccable patient experience and treat everyone like family. The Medical Billing & Back Office Specialist will be a trusted team member providing care to our patients and a trusted partner to the clinical team, center staff, and the Executive Leadership team.
Responsibilities
- Review clinical documentation to ensure support for codes billed.
- Edit appropriate modifier usage & diagnosis codes for accurate claims submission.
- Reviews all rejected claims for corrections.
- Applying patient payments to claims created.
- Position Purpose: To process medical billing claims, collect patient or provider payments, resolve questions and problems with a customer's account, process patient refunds, appeals to include re-determinations and resubmissions of billing to patient payers.
- Process medical data relevant to medical billing, charge entries, payment posting and update the electronic medical records system.
- Review rejected claims and taking necessary steps to finalize claim, to include reverification of insurance, obtaining prior authorizations, contacting Payor, physician offices & patients.
- Ensure copay's are collected or billed to appropriate Payor.
- Answer inbound billing phone calls as needed.
- Maintain confidentiality of all patient and financial information.
- Prepare various reports in Excel as instructed by Supervisors.
- Verify entered data by reviewing, correcting, deleting, or reentering data, combining data from multiple systems.
- Fulfill targets with diligence and responsibility.
- Manage Email and phone communication with clients and team members.
- Maintain operations by following compliance policies and procedures; reporting needed changes.
- Maintain customer confidence and protects operations by keeping information confidential.
- Contribute to team effort by accomplishing related results as needed.
- Exhibit professional excellence, teamwork and integrity.
- Performs other duties and tasks as assigned, depending on work schedules and priorities.
Qualifications
- Minimum Experience: 2 years' experience in medical billing, specifically charge entry and payment posting.
- Experience Plus: Knowledge of electronic medical records systems and experience in processing.
- When information is incomplete; purging files to eliminate duplication of data.
- The ability to effectively multi-task is a must.
- Knowledge of medical referrals, medical eligibility checks and document management.
- Knowledge of reimbursement guidelines, CPT and ICD-10codes, payor contracts and plans.
- Must have good computer/typing skills.
- Need good documentation skills.
- Should have a strong understanding of Microsoft Excel, Word and Email systems.
- Should have good command over spoken and written English.
- Attention to details and research expertise.
- A good team member with highly effective communication skills.
- Must have research skills on Internet.
- Experience, skills, proficiency in English and sincerity at work.
- High School graduation is required, and Medical Billing certification preferred
- Must be eligible to work in USA.
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