Medical Billing Specialist

I AM NOT INTERESTED AT ALL IN OUTSOURCING. NO BILLING SERVICES WILL BE CONSIDERED!!!

THIS IS AN ON-SITE POSITION ONLY!

In this position, you will be responsible for submitting inpatient and outpatient claims, and providing claims follow up for any and all payers. You will need to be able to multitask and prioritize responsibilities. The Medical Billing Specialist is an essential supporter of the mission, vision and values of the organization and maintains the highest degree of confidentiality in patient and staff, fiscal and organizational matters. Understands and adheres to all HIPAA regulations and requirements. 

Essential Functions

• Prepares and submits clean claims to various insurance companies and payers, either electronically or on paper
• Participates in identifying and resolving patient billing concerns
• Corrects coding errors and resubmits claims to payers
• Follow up on unpaid claims within the standardized billing cycle timeframe
• Checks “superbills" for accuracy prior to entering into the system
• Researches payment denials and re-submit for payment as necessary
• Analyzes and processes requests for refunds and credits 
• Ability to answer all patient or insurance company inquiries pertaining to any account
• Outstanding time management and problem solving skills
• Must be well organized and detail-oriented
• Provides courteous and timely assistance to internal and external customers

Education, Knowledge and Experience:

• High School Diploma or GED required. AA degree in business or any healthcare discipline, a plus.
• Minimum three (3) years’ experience as a Biller or Collector. Outpatient/Inpatient billing and Specialty billing, a plus Well-rounded extensive knowledge of medical terminology, billing procedures as well as CPT and ICD-10 coding
• Extensive experience and knowledge in Medicare, California State Medi-Cal, Work Comp, Managed Care and other medical/health insurances reimbursement principals 
• Proficient in written and spoken English. Bilingual in Spanish, a plus
• Data entry skills should be exceptional; skills in self-proofing essential
• Ability to use critical thinking skills to interpret information furnished in written and oral form, and problem solve by researching to obtain resolute information 
• Sound decision making ability to prioritize tasks based on available information
• Evaluates situations and requirements in order to plan and adjust work accordingly
• Above average math skills to add, subtract, multiply and divide.

Software and Equipment:

• Uses Microsoft Word, Excel, Outlook, Email, Internet, proficiently
• Experience working with an EMR and billing software, (Office Ally experience is a plus)
• Uses dedicated software to perform billing tasks. Prior experience with Office Ally a plus
• Ability to learn new programs quickly
• Ability to use standard office equipment

Environmental/Working Conditions:

• Customary medical business office environment. 

Physical Demands:

• Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a computer keyboard and other standard office equipment.
• This job description is intended to provide basic guidelines for meeting job requirements. 
• Responsibilities, skills and working conditions may change as needs evolve.