Medical Billing Specialist

Robert Half is looking for a Medical Billing Specialist for our Healthcare client. This position plays a crucial role in the healthcare revenue cycle, ensuring accurate and timely processing of Medical Billing claims. This role involves translating medical procedures and services into billing codes, submitting claims to insurance providers, and following up on outstanding balances. The Medical Billing Specialist must possess a deep understanding of medical coding, billing regulations, and insurance procedures to maximize reimbursement for healthcare services.

Key Responsibilities:

Claim Generation and Submission:

• Translate medical services and procedures into accurate billing codes.
• Prepare and submit medical claims to insurance companies electronically or by paper as required.

Insurance Verification:

• Verify patient insurance coverage and eligibility before claim submission.
• Update and maintain accurate insurance information in the billing system.

Payment Posting and Reconciliation:

• Post payments received from insurance providers and patients.
• Reconcile payments against billed amounts and identify discrepancies.

Denial Management:

• Investigate and appeal denied or rejected claims.
• Collaborate with insurance companies to resolve claim discrepancies and ensure accurate reimbursement.

Patient Billing and Follow-up:

• Generate patient statements and invoices.
• Follow up with patients on outstanding balances, providing explanations and assistance as needed.

Coding Compliance:

• Ensure accurate application of medical codes (ICD-10, CPT, HCPCS) to maximize reimbursement.
• Stay informed about coding updates and changes in healthcare regulations.

Documentation and Recordkeeping:

• Maintain organized and accurate records of billing activities.
• Document interactions with insurance providers, patients, and internal stakeholders.

Revenue Cycle Optimization:

• Identify opportunities for process improvement within the revenue cycle.
• Collaborate with other healthcare professionals to streamline billing processes.

Compliance with Regulations:

• Stay abreast of healthcare regulations, including HIPAA and other relevant billing guidelines.
• Ensure compliance with ethical and legal standards in Medical Billing practices.

Communication and Collaboration:

• Communicate effectively with internal teams, including physicians, nurses, and administrative staff.
• Collaborate with colleagues to resolve billing-related issues and enhance overall efficiency.

For further consideration please contact Narghes the Talent Manager at 916-273-9750.

Qualifications:

• Previous experience in Medical Billing, coding, or a related field.
• Proficiency in medical coding systems (ICD-10, CPT, HCPCS).
• Familiarity with billing software and electronic health records (EHR).
• Strong knowledge of insurance procedures, reimbursement policies, and healthcare regulations.
• Excellent attention to detail and accuracy in data entry.
• Effective communication skills for interacting with patients, insurance providers, and internal stakeholders.
• Ability to prioritize tasks and manage time efficiently.
• Understanding of the healthcare revenue cycle.