Medical Billing Specialist

Benefits 401(k) 401(k) matching Dental insurance Health insurance Paid time off Training & development Vision insurance Qualifications High School Diploma or Equivalent required Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems Proficient in Microsoft Word, Outlook, Excel, and 10 key calculators Basic knowledge of medical terminology, including CPT/ICD-10 coding Effective communication abilities for phone contacts with insurance payers to resolve issues Knowledge of medical terminology likely to be encountered in medical claims Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Planning and organizing Attention to detail, accuracy, and efficiency Problem-solving Teamwork Multitasking Customer service Electronic Medical Records (EMR) Communication skills - verbal and written Integrity Prolonged periods sitting at a desk and working on a computer Must be able to lift up to 15 pounds at times Responsibilities The Billing Specialist is responsible for posting insurance payments, entering charges, and assisting patients with their accounts Position requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, co-pays, deductibles, allowable, CPT codes and Dx codes Work with personal information and maintain patient confidentiality Weekly and monthly reporting to executive director and billing supervisor Verify the accuracy of all claims before submission and ensure all claims are submitted with a goal of zero errors and review claims and claim denials to ensure maximum reimbursement for services provided Utilize monthly aging accounts receivable reports for follow-up on unpaid claims aged over 30 days Review referrals and authorizations Respond to questions and complaints from patients or insurance companies Research and appeal denied claims Read and interpret insurance explanation of benefits and respond to inquiries from insurance companies, patients, and providers Other responsibilities as judgment or necessity dictate Become OCSR (Ophthalmic Coding Specialist- Retina) certified in the first 6 months of employment. All associated costs covered. Meet defined department goals and activity metrics Initiate late payment notices to relevant parties Identify and bill secondary and/or third-party insurances Follow set billing processes and procedures and follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO Ensure patient information is accurate and complete and request any missing patient information Create both paper and electronic copies of documentation Collect delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur #J-18808-Ljbffr TEXAS MACULA & RETINA PLLC