What are the responsibilities and job description for the Medical Billing Specialist position at Coastal Spine & Pain Institute?
Education and Experience Required
- A high school diploma
- Knowledge of business and accounting processes. Medical billing & coding certificate. A degree in Business Administration, Accounting, or Health Care Administration preferred.
- A minimum of one to three years of experience in a medical office specialty setting.
Knowledge, Skills, and Abilities required:
- Checking eligibility and benefits verification for office visits, treatments, and procedures.
- Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle timeframe.
- Checking each insurance payment for accuracy and compliance.
- Calling insurance companies regarding any discrepancy in payments if necessary.
- Identifying and billing secondary or tertiary insurances.
- Reviewing accounts for insurance of patient follow-up.
- Researching and appealing denied claims.
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
- Setting up patient payment plans and work collection accounts.
- Updating billing software with rate changes.
- Updating cash spreadsheets, and running collection reports.
- Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
- Competent use of computer systems, Eclinical works software, and 10 key calculators.
- Familiarity with CPT and ICD-10 Coding and modifiers.
- Effective communication abilities for phone contacts with insurance payers to resolve issues.
- Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
- Ability to work well in a team environment. Being able to triage priorities and handle conflict in a reasonable fashion.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
- A calm manner and patience working with either patients or insurers during this process.
- Collection and posting of payments received.
- Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
Schedule:
- Monday to Friday
Work Location: In person