Medical Billing Specialist

JOB TITLE: Medical Billing Specialist

DEPARTMENT: Billing

FLSA STATUS: Non-Exempt, Grade 902

REPORTS TO: Revenue Cycle Manager

Location: On site - Lenexa, Kansas

COMPANY OVERVIEW

MAWD Pathology Group is a physician owned pathology practice committed to excellence in patient care. Everything in MAWD’s organization – our commitment to service, the quality of pathologists and supporting staff we recruit, the accountability we require of our staff, the collegial work environment we nurture, our focus on smart business and the services we choose to offer – is shaped by our underlying commitment to excellence for our patients. It’s the MAWD Way.

POSITION SUMMARY

The Medical Billing Specialist helps to calculate and collect payments for medical procedures and services. Their work includes updating patient data, developing payment plans, and preparing invoices. The medical billing specialist helps make sure an organization keeps a consistent revenue and works with insurance companies to ensure claims are paid on a consistent basis.

ESSENTIAL FUNCTIONS

• Investigate and process denials promptly

• Monitor accounts receivable aging reports, follow up on outstanding claims, and work to resolve any discrepancies or issues to ensure timely payment and reduce outstanding balances

• Ensure all claims are submitted daily with a goal of zero errors.

• Reading and interpreting medical coder information

• Responding to inquiries from patients, providers, and clients

• Ensuring adherence to and compliance of external (HIPAA) and internal system regulatory policies.

• Retrieving missing data

• Collaborates with Revenue Cycle Departments to ensure all bills are satisfied in a timely manner.

• Prepare and submit billing data to insurance companies.

• Ensure the patient’s medical information is accurate and up to date.

Management reserves the right to add, modify, change or rescind the work assignments of this position as business needs warrant.

COMPETENCIES

• TECHNICAL EXPERTISE – The incumbent demonstrates the technical capability and knowledge required for this role

• QUALITY CONTROL – This role demonstrates accuracy and thoroughness and monitors own work to ensure quality

• INTERPERSONAL SKILLS – This role maintains confidentiality, remains open to others’ ideas and exhibits a willingness to try new things

PERFORMANCE MEASUREMENTS

• Independently performs tasks of a routine nature

• Consistently delivers quality work during allotted timeframes

• Understands and ensure compliance with our Data Protection policies and procedures

• Excellent core value performance

QUALIFICATIONS AND REQUIREMENTS

Education:

High School diploma or equivalent required

Associates Degree preferred

Required Qualifications:

• 1-2 years of medical billing experience in healthcare setting, preferably in anatomic pathology

• Experience with various billing software systems (i.e. HealthPac, XIFIN, Imagine, etc.)

• Demonstrated proficiency with federal, state, and commercial insurance reimbursement regulations

• Knowledge of Federal, state, and HIPAA privacy regulations

Required Qualifications (Continued):

• Ability to interact and collaborate with internal and external professionals

• Exceptional verbal and written communication aptitude, with proven ability to positively influence behavior

• Process and operational improvement experience

• Highly self-directed, motivated and able to work independently with minimum level of supervision

• Professional, courteous demeanor and attire

• Excellent administrative and organizational skills

• Detail oriented while keeping broader perspectives in sight

• Strong computer skills a necessity

• Excellent interpersonal skills including conflict management

• Strong understanding of Healthcare Revenue Cycle and client management

• Solid technical skills to support multiple systems and technology platforms

TRAVEL AND HOURS

• This position is full-time

• No travel is required with this position

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• employee is regularly required to talk or hear

• employee frequently is required to stand, walk and use hands / fingers

• employee is occasionally required to lift office products and supplies, up to 20 pounds.

EEO STATEMENT

It is the policy of MAWD Pathology Group to provide equal employment opportunities to all individuals regardless of their race, creed, color, religion, sex, age, national origin, disabilities, veteran status, marital status, sexual orientation, military status or any other characteristic prohibited by state or federal law.