Medical Billing Specialist

The Medical Billing Specialist is responsible for providing selective medical billing services to a variety of clients within the post-acute healthcare industry, including nursing, retirement communities, home health and hospice facilities. They handle third-party billing and any denials after the claim is submitted while providing excellent client service.

Success Factors

Responsibilities

• Train with Medical Billing Senior Specialist and Manager to learn billing procedures and claim follow-up on the numerous systems clients utilize
• Establish collaborative working relationship with Medical Billing Senior Specialist and Manager to assist with any client needs that arise
• Learn and understand Medicare, Managed Care, and Medicaid regulatory billing practices
• Review claims against medical documentation provided by clients to ensure clean claims are submitted to the appropriate third party payer
• Communicate with Medical Billing Senior Specialist and Manager when claims require additional information prior to submission
• Complete coinsurance billing to appropriate secondary or tertiary insurances
• Stay abreast of current medical coding and billing issues, trends and changes in the laws and regulations in order to make recommendations for changes in policies and procedures
• Investigate, manage and resolve medical claims in accordance with established requirements and procedures
• Consistently follow up on unpaid claims using monthly aging reports
• Analyze accounts and investigate claims that have been returned, denied or have balance inaccuracies
• Communicate with Medical Billing Senior Specialist and Manager on troublesome accounts receivable balances
• Provide timely and high quality service to meet and exceed client expectations and perform research on projects as needed
• Take initiative to understand and apply available resources and appropriate guidance and policies
• Organize facts, analyze and interpret information according to client circumstances
• Other duties as assigned

People Management/Relationships

• Take initiative to be a team player (seek out opportunities to help others)
• Treat everyone with respect
• Develop loyalty and trust with team
• Successfully adapt to different personalities and working styles
• Proactively and effectively communicate information regarding status issues to team members
• Hold self accountable for assigned work; seek continuous feedback to learn and develop in role; open to new ideas and suggestions
   

Required Skills

• Excellent organization skills and strong attention to detail
• Multitasker with the ability to prioritize work accordingly
• Excellent verbal and written communication skills with strong client service focus
• Strong analytical and interpersonal skills
• Ability to work autonomously under the pressure of tight deadlines and multiple priorities

Education, Experience and Certifications

• High school diploma or equivalent (GED); Associate’s degree and medical billing certification a plus
• 1+ year experience in an administrative function, preferably within the health care field
• Strong knowledge of Microsoft Office suite products and technology-savvy individual
• Excellent attention to detail with the ability to manage multiple projects
• Ability to research and analyze data and resolve issues; read and interpret medical terminology
   

Essential Functions

• Must be able to remain in a stationary position as needed
• The person in this position needs to occasionally move about inside the office and at client offices to access file cabinets, office machinery etc.
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer
• Ability to communicate in a professional manner and exchange information with internal and external actors as needed
• Ability to lift/carry up to 20 pounds
• Ability to work outside of normal business hours and weekends as needed
• Ability to travel to local and non-local clients as needed, overnight travel may be required
• This job description is subject to change at any time and employee will be given additional responsibilities as assigned.

Salary Range: