What are the responsibilities and job description for the Rheumatology Medical Biller Specialist (5+ Years of Experience) position at Healthteq Services?
Job Description
Job Description
Job Summary :
We are seeking an experienced Rheumatology Medical Biller Specialist with over 5 years of experience in medical billing and coding, specifically in rheumatology. The ideal candidate will possess in-depth knowledge of billing procedures, insurance guidelines, and coding for rheumatology-specific services such as infusions, diagnostic imaging, and lab tests. This role requires precision, organization, and a deep understanding of revenue cycle management to ensure accurate billing and prompt reimbursement.
Key Responsibilities :
- Specialized Billing & Coding : Accurately process claims for rheumatology services, using ICD-10, CPT, and HCPCS codes for treatments like biologics, infusions, and diagnostic procedures.
- Claims Management : Submit, track, and resolve unpaid or denied insurance claims, ensuring adherence to Medicare, Medicaid, and private insurance policies.
- Prior Authorizations : Coordinate and secure pre-authorizations for medications and treatments commonly used in rheumatology practices.
- Accounts Receivable Management : Monitor and manage patient accounts, post payments, and ensure timely follow-up on outstanding balances.
- Insurance Verification : Confirm insurance eligibility and benefits for rheumatology-specific procedures and treatments.
- Compliance & Regulations : Ensure compliance with HIPAA regulations and current billing standards, including knowledge of payer-specific guidelines.
- Provider Communication : Collaborate with rheumatologists and other healthcare providers to resolve coding and billing discrepancies.
- Reporting : Generate reports on billing trends, revenue cycle performance, and areas for optimization.
Qualifications :
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