Medical Billing Specialist

Genesis Surgery Center (ASC) Billing Specialist is responsible for managing and overseeing the billing process for all medical services provided in the surgical center. The role requires in-depth knowledge of healthcare billing, coding, and insurance requirements to ensure that all claims are processed and paid accurately and efficiently. The Billing Specialist will collaborate with healthcare providers, insurance companies, and patients to resolve billing discrepancies and ensure timely payment.

Key Responsibilities:

• Billing and Coding:
• Review and verify medical charts, procedures, and patient records to ensure accurate coding for surgeries and related services.
• Prepare and submit claims to insurance companies and third-party payers using appropriate CPT, ICD-10, and HCPCS codes.
• Ensure compliance with all healthcare billing regulations, including HIPAA, CMS, and payer-specific guidelines.
• Claims Management:
• Monitor the status of insurance claims, following up on unpaid or denied claims to ensure timely resolution.
• Work with insurance representatives to clarify discrepancies and resolve issues related to claim denials, rejections, or underpayments.
• Maintain a current understanding of insurance contracts and policies to ensure correct billing practices.
• Payment Posting and Reconciliation:
• Post insurance and patient payments to accounts accurately and in a timely manner.
• Reconcile accounts to ensure payments match billed amounts and address any discrepancies.
• Patient Billing:
• Generate patient statements and follow up on outstanding balances or payment arrangements.
• Address patient inquiries regarding billing issues and provide clarity on charges, insurance payments, and patient responsibility.
• Work with patients to set up payment plans as necessary.
• Reporting and Documentation:
• Generate and maintain billing and payment reports for management and auditing purposes.
• Maintain detailed records of claims submissions, follow-ups, denials, and resolutions for audit purposes.
• Customer Service and Communication:
• Provide excellent customer service to patients, insurance companies, and healthcare providers by responding to inquiries and addressing issues promptly.
• Communicate effectively with surgeons, nurses, and other healthcare staff to ensure that all charges are accurately documented and coded.
• Compliance and Training:
• Stay up to date with changes in healthcare billing codes, regulations, and payer policies.
• Assist with internal audits to ensure billing practices meet regulatory and compliance standards.
• Participate in ongoing education and training to enhance knowledge of billing practices and codes.

Qualifications:

• High school diploma or equivalent required; Associate’s degree or certification in medical billing and coding preferred.
• Certification in medical billing and coding (e.g., CPC, CCS) is highly preferred.
• Proven experience as a billing specialist in an ambulatory surgical center, outpatient setting, or healthcare-related field.
• In-depth knowledge of ASC billing procedures, coding (CPT, ICD-10, HCPCS), insurance verification, and healthcare billing regulations.
• Familiarity with electronic health record (EHR) systems and medical billing software.
• Strong attention to detail, organizational skills, and the ability to work under tight deadlines.
• Excellent verbal and written communication skills.
• Ability to work independently and as part of a team.

Work Environment:

• This position is based in an office setting within an ambulatory surgical center.
• Standard working hours, with occasional overtime as necessary to meet deadlines.

Job Type: Full-time

Pay: $19.00 - $24.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Revenue cycle management: 2 years (Preferred)
• Medical Billing: 2 years (Required)

Work Location: In person

Salary : $19 - $24