Medical Billing Specialist Jobs

Billing Specialists must be able to work with medical billing and collection activities to include Medicare, Medicaid, commercial Insurance and Private Pay accounts. Participates in billing systems design to ensure maximum collection of revenue. Scrub, generate and transmit claims. Serve as resource for the department; must be able to answer questions, assist with problems, and provide direction. Coordinate, educate and interact with physicians, clinical staff, employees and other departments and managers in regard to billing department practices. Provides proper customer service (internal/external) at all times.

• Keeps current with changes in the law that affect physicians, payers and providers, use proper CPT Diagnosis Codes and Units, etc.
• Work with correspondence daily.
• Vision Plans: online submission of all vision plans through insurance portals. Block Vision Optical submission of billing claims.
• Ensures that all medical staff members are credentialed accordingly.
• Reports all delinquent fees.
• Assists with processing of all secondary claims/accounts.
• Calculates charges, composes bills, sends statements, processes payments, etc.
• Veterans Affairs: receive and upload vouchers, send secondary authorization requests for follow-up visits, or surgical authorizations, apply payments, rebill claims.
• Participates in billing systems designed to ensure maximum collection of revenue; responds to issues and concerns of the Billing team.
• Researches/verifies patient accounts to ensure payments are being credited to the proper accounts and that balances are being paid.
• Works all Medicare denials, appeals, rebills claims for reimbursement.
• Ensure that all front office staff is appropriately trained concerning issues that pertain to billing: Insurance cards, Demographics, “All Fields Required”.
• Ensure to keep work areas clean and organized at all times.
• Works closely with DARS (State, Outreach, Rehab, and TWC) and ensures payment by coordinating all processing of paperwork.
• Fields calls from patients, insurance companies, and healthcare professionals.
• Prepares payment plans for patients needing to make financial arrangements.
• Other duties as assigned.
• Tracks billing, monitors collections and compiles information for month end reports.
• Accounts Receivable: post payments of live checks, and EOB’s, reconcile, and submit report to Finance.
• Coordinate, educate and interact with physicians, clinical staff, employees and other departments and managers in regard to billing department practices
• Obtain Pre-Authorizations from state funded program for office visit and Visual Field. (Not for follow-up treatment), upon receipt of evaluation; must attach clinic notes, results, update reports.
• Able to work with medical billing and collection activities to include Medicare, Medicaid, commercial Insurance and Private Pay accounts.
• Collections: Look at Envolve claims (EOB’s, denials) correcting diagnosis codes, and resubmitting claims.