What are the responsibilities and job description for the Medical Billing Specialist position at The Doctors Center?
We are looking for a dedicated Medical Billing Specialist to join our healthcare team. As a Medical Billing Specialist, you will be working in a fast-paced and growing organization where you will be relied on for your expertise, professionalism, and teamwork.
Responsibilities & Duties
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This position is responsible for collecting outstanding receivables from insurance companies, patients, and physicians
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Provide excellent customer service to patients, providers, and other customers
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Work in a high-volume medical collections environment while maintaining exceptional standards of excellence
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Follow through on rejected or denied claims, contacting third-party payers and/or patients for timely payment resolution
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Ability to accurately review and bill all secondary and tertiary insurances to correct charges, bill forms, and supporting documentation (EOBs)
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Appropriately identify rejected or denied claims, work to ensure that trends are identified and resolved quickly
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Maintain daily billing queues by working and reporting claim edits or following up on claim issues
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Work independently while maintaining confidentiality and following HIPAA regulations
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Maintains work operations by following policies, procedures, and reporting compliance issues
Qualifications
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High school diploma or equivalent
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3 years of billing experience required
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Previous years’ experience in primary care is a plus
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Experience using Athena preferred
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Knowledge of insurance payer requirements as it relates to benefit coverage, referrals, and authorizations
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Knowledge of processes and methods for maintaining clear and precise notes received from insurance payers related to insurance verification and communication with payers
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Knowledge of insurance billing and collection guidelines including HMO/PPO, Medicare, Medicaid, other third-party payers, HCPC, CPT, ICD-10, coding and medical terminology, LCDs (Local Coverage Determinations), payer billing guidelines and medical policies
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Knowledge of working in online payer portals such as: Availity
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Knowledge of computer systems, programs, data entry, and spreadsheet applications is essential, including knowledge of MS Office applications including MS Word, PowerPoint, and Excel
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Detail-oriented self-starter with a strong work ethic
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Knowledge and understanding of legislation and regulations regarding healthcare practices and CMS regulations
