Medical Billing Specialist

The Medical Payment Poster and Billing Specialist helps the healthcare facility manage insurance claims, invoices, and payments.

Primary Responsibilities

POSITION SUMMARY: Responsible for posting all payments and adjustments to patient accounts

• Utilizing various reports to balance payments on the daily.

• Processes patient and insurance payments and appropriate adjustments to patient accounts.

• Evaluates EOB's for the need for an appeal for reduced payment or CPT denial.

• Evaluates EOB's for the need for research by an AR Representative for possible error in claim submission or entire claim denial.

• Resubmitting corrected claims.

• Working A/R projects as requested by billing manager.

• Print HCFAs and attach primary EOBS for secondary claims processing.

• Documents all interactions on an account- clear and concise.

• Any other duties as assigned by manager.

• Helps answer calls incoming to billing department.

Knowledge, Skills and Qualifications

· Knowledge of insurances and benefits/eligibility verification such as Medicare, Medicaid and replacement plans

· I.H.S.- Indian Health services and PRC experience

· eClinical Works (ECW –EMR) Experience

· Ability to multi-task

· Microsoft Office skills

· Professionalism, confidentiality, and strong work ethic

· Typing

· Verbal Communication

· Reliable transportation to and from work (shifts will be 8 hours a day Monday- Friday)

Reports To

· Billing Manager