Medical Billing Specialist

Job Description

Job Description

We expect the Chiropractic & Acupuncture Medical Biller to manage the practice's revenue cycle. This role requires specialized knowledge of time-based acupuncture coding and chiropractic-specific modifiers to ensure reimbursement for same-day evaluation and treatment.

Core Responsibilities

• Chiropractic and Acupuncture Coding: Be able to code properly from the doctor's notes and add proper modifiers needed per insurance company.
• Diagnosis Alignment: Ensure ICD-10 codes align with specific payer "medical necessity" lists, such as Medicare's restriction of acupuncture to chronic low back pain.
• Personal Injury & Workers' Comp: Manage complex "Third-Party Payer" claims involving attorneys, lien settlements, and specialized documentation for accident cases.
• Documentation Auditing: Review clinical SOAP notes to ensure they distinguish between "Active Care" (billable) and " Maintenance/Wellness Care" (typically patient-pay).
• KPI Monitoring: Conduct weekly reviews of the practice's "Aging Report" to identify and resolve "stuck" claims before they reach the 60-day mark.
• Audit Readiness: Periodically audit high-frequency codes to ensure they align with clinical documentation and don't trigger "statistical anomaly" flags.
• Efficiency Optimization: Implement automated eligibility checks to reduce common front-end denials.
• Patient Billing: generate superbills for patients, including the correct medical billing codes, and speak to patients about payment plan options
• Give Weekly and Monthly Provide : Be able to provide weekly and monthly A/R, denial, and collection rates, and aged assets performance to see our performance and identify opportunities to enhance our revenue.

Specialized Skills & Qualifications

• Coding Proficiency: Deep familiarity with Chiropractic Manipulative Treatment ( CMT ) codes, modality codes, and acupuncture-specific codes.
• Regulatory Knowledge: Understanding of specific Medicare rules for chiropractic, such as the requirement for X-ray evidence or specific physical exam findings (P.A.R.T. criteria).
• Software Skills: Experience with Jane App preferred, but not necessary. We are willing to train on the software.
• Patient Education: Ability to explain "Maintenance Care" policies and convert patients to cash-pay or membership plans once insurance benefits are exhausted. Duties:

As an employee, you are required to have a chiropractic assistant license. We will train and provide all necessary education to help you get your licensure. With this license, you will be able to perform modalities and basic intakes on patients.

We expect each of our employees to work as a team, to communicate effectively, and to come to work with a positive attitude. We treat our patients with kindness and empathy, and expect all of our employees to show that with every patient.