Medical Billing Specialist

Medical Billing SpecialistRevenue Cycle Management is looking for a full-time Medical Billing Specialist to join our team! Hybrid opportunity after 90 days of in-person training (2 days from home, 3 days in office).The Medical Billing Specialist is responsible for analyzing patient's records and coding the patient's records based on ICD-10 and CPT codes. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections.Essential Functions:Reviews patient accounts and supporting documentation to ensure all billable services and charges are captured accuratelyValidates diagnosis and procedure codes on accounts for billing accuracy and payer requirements; escalates discrepancies for correctionCommunicates with clinical, coding, and front-end teams to obtain or clarify missing or incomplete informationPrepares and submits accurate electronic and paper claims to commercial insurance carriers and government payersInvestigates and resolves claim denials and rejections, including appropriate corrections and resubmissionsMaintains accurate and up-to-date patient account information within the electronic medical record (EMR) and billing systemsIdentifies trends or recurring issues impacting reimbursement and communicates findings to leadershipEnsures compliance with payer guidelines, company policies, and applicable regulationsPerform other related tasks as neededKnowledge, Skills, and Abilities:Knowledge of medical billing processes, including insurance verification, prior authorization, patient responsibility, and workers' compensationKnowledge of explanation of benefits (EOBs), remittance advice, and coordination of benefits (COB) processingWorking knowledge of medical terminology and ICD-10, CPT, and HCPCS coding systems as they relate to billing accuracyKnowledge of payer guidelines, including government and commercial insurance requirements, claims submission, and denial managementProficient in electronic billing systems and claim forms, including HCFA Form CMS-1500Experience with electronic medical records (EMR) and practice management systemsStrong analytical and problem-solving skills with the ability to identify and resolve billing discrepanciesHigh attention to detail and accuracy in reviewing and processing claimsStrong organizational and time management skills with the ability to prioritize tasks effectivelyAbility to work independently with minimal supervision and adapt to changing prioritiesEffective written and verbal communication skills, including the ability to communicate professionally with internal teams and external partiesProficient in Microsoft Office applications, including Word, Excel, and PowerPointEducation and Experience:High School Diploma or GEDThree (3) years of experience with medical billing, accounts receivable, or revenue cycle operationsMedical billing certification in lieu of experienceBenefits:3 Medical Plans2 Dental Plans2 Vision PlansEmployee Assistant ProgramShort- and Long-Term Disability InsuranceAccidental Death & Dismemberment Plan401(k) with a 2-year vestingPTO + Holidays