Job Description
Description/Overview: An intermediate level Medical Billing Specialist plays a crucial role in the healthcare industry by ensuring accurate and timely processing of medical claims and invoices. Responsibilities include reviewing patient records, verifying insurance information, coding diagnoses and procedures, submitting claims to insurance companies, and following up on outstanding payments. The specialist must have a strong understanding of medical terminology, billing practices, and insurance regulations to optimize revenue cycle management and maintain compliance with industry standards. Effective communication skills, attention to detail, and proficiency in billing software are essential for success in this role..
Responsibilities
-a) Monitors insurance claims and patient accounts in work queues to ensure they are billed and worked within BAMCs guidelines. b) Manages and works assigned queues to appropriately process claims, including clearing house claims. c) Research issues and correct claims that prevent transmission to insurance companies. d) Coordinates with the coding department to clarify questions pertaining to documentation on the claim. e) Verifies the patient insurance information is correct in Electronic Health Record (EHR) and/or on claim forms. f) Generates industry standard healthcare claim forms for outpatient, inpatient services, and observation and ambulatory procedures.
Qualifications
- a. Certified Professional Biller (CPB) –or b. Certified Billing and Coding Specialist (CBCS) –or c. Associate college degree in medical billing/coding –or d. Possess a minimum of 1 years of experience within the past 3 years, in private sector (non-DOD or VA). Experience must include working with a variety of health insurance companies, Medicare/Medicaid, as well as medical billing and collections.
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