Medical Billing Claims Specialist

Job TitleSummit Spine and Joint Centers (SSJC) is seeking a motivated, qualified professional for a remote position.Job DutiesThe ideal candidate will be responsible for:Auditing and ensuring claim information is complete and accurate.Submitting claims for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.Ensuring accurate and timely billing of HCFA 1500 claims.Documenting files with appropriate information.Creating logs for providers of pending medical encounters and or encounters with errors.Working directly with other billing staff and management to meet end of month closing deadlines.Handling clearinghouse rejections, printing, and mailing secondaries.Addressing inquiries from insurance companies, patients, and providers.Understanding CPT, ICD10, HCPCS coding and modifiers.Having knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc.Understanding ERAs, EOBs, and payer specific/LCD guidelines.Understanding health plan benefits (deductibles, copays, coinsurance) and eligibility verification.Being proficient with spreadsheets and word processing applications.QualificationsThe candidate should have:Minimum of 3 years' experience with medical billing or revenue cycle in a medical setting.Experience with Medicare, Medicaid, Commercial insurance plans, Workers' comp, and Personal Injury cases.Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required.Excellent computer skills and familiarity with Microsoft Office.Comfortable working in a growing, dynamic organization and able to navigate change.Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment.Bachelor's degree preferred.Experience using eClinicalWorks preferred.Experience with Pain Management preferred.Preferred LocationWhile this is a remote position, preference will be given to candidates residing in one of the following states:GeorgiaTexasNorth CarolinaSouth CarolinaFloridaCandidates located in Georgia should be able to attend meetings or training at our Lawrenceville administrative office as needed.Compensation & BenefitsThis is a full-time position offering a competitive salary, paid time off (PTO), comprehensive health benefits, and a 401(k) with company match.