Medical Billing Specialist

Job Summary: Medical Billing Specialist, is responsible for organizing patient medical costs and sending invoices to collect payment from patients and their insurers. The duties include calling patients to discuss payment and develop reasonable payment plans, entering patient data into administrative systems and recording information about outstanding claims. Follows regulations and guidelines for the position.

Primary Job Duties

• Perform billing for all claims
• Identify and resolve rejections for claims
• Determine root causes(s) that resulting in the rejected claim (i.e., 2 primary insurances, wrong demographic info, missing documentation, incorrect modifier, etc.)
• Resolve issues and recommend procedural changes to prevent further rejections
• Resubmit/refile claims and appeal rejected claims as necessary
• Ability to explain EOBs regarding patient's insurance benefits for the requested service and ability to provide supporting documentation as needed (i.e., fee schedule, contractual obligations, deductible status of plan, etc.).
• Maintain current documentation related to the patient's claims, denial and appeals
• Refer complex issues to the supervisor for review and or action
• Adhere to contractual requirements of Medicare, and managed care plans
• Ensure a continuous quality improvement customer service approach by proactively identifying areas of improvement and communicating those ideas to the healthcare team
• Cross-trains in collection to research rejected claims, communicate denied claims, and adhere to contractual requirements of Medicare and managed care plans
• Should be able to handle incoming patient calls regarding to account status and outstanding balances
• High biller production level

Job qualifications:

• High school diploma or equivalent
• Basic computer skills including familiarity with electronic medical records
• Types 25 words per minute with 96% accuracy
• Repeating motions that may include the wrists, hands and/or finger
• Detail oriented with excellent interpersonal communication skills
• 2-5+ years of experience in outpatient billing and collections
• Knowledge of Commercial and Government payor and Worker's Comp guidelines
• Proficient in medical terminology, HIPAA, and other critical governmental regulations
• Organized, detailed-oriented, and ability to meet deadlines
• Communicating with others to exchange information
• Assessing the accuracy, neatness and thoroughness of the work assigned
• Ability to comprehend various insurance documentation, analyze and reconcile accounts and follow detailed procedures in an

Expectations:Attendance and punctuality is necessary. Ability to work well with a multidisciplinary team. Ability to problem solve and be self-motivated. Must have a commitment to excellence and high standards. Must have excellent written and oral skills, strong organizational, problem-solving and analytical skills. Must have ability to multitask, manage priorities and workflow. Required to have versatility, flexibility and a willingness to work within constantly changing priorities with enthusiasm and have acute attention to detail. Able to operate computer software with training. Expected to have strong interpersonal skills and have the ability to understand and follow written/verbal instructions. Able to work independently with little or no supervision. Required to have the ability to deal effectively with a diversity of individuals at all organizational levels and with external customers.

Vital Med Urgent Care, LLC strives to maintain a workplace that accepts and appreciates the differences among our employees. The company will not discriminate against any applicant or employee based on age, race, gender, color, religion, national origin, ancestry, disability, marital status, covered veteran status, sexual orientation, gender identity and/or expression, genetic information, status with respect to public assistance or any other characteristic protected by state, federal, or local law.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• 10 hour shift
• 12 hour shift
• 8 hour shift
• Monday to Friday
• Weekends as needed

Experience:

• EMR systems: 1 year (Preferred)
• Vital signs: 1 year (Preferred)

License/Certification:

• BLS Certification (Preferred)
• Certified Medical Assistant (Preferred)

Work Location: In person