Medical Billing Specialist

Job Description

Medical Billing Specialist

Medical Billing Specialist is responsible for handling all types of insurance claims, including private, Medicare and Medicaid. They are responsible for both patient and insurance collections and making sure claims are processed in a timely manner so that the organization is properly reimbursed for services provided. This includes working on follow-ups, denials, and refunds.

Essential Duties/Responsibilities:

• Patient demographics and insurance verifications are confirmed
• Charge entry: All visits are checked for retrievable/appropriate ICD-9/ICD-10 and CPT codes, according to insurance guidelines.
• Approved visits are batched and sent electronically to the insurance company via clearinghouse. Paper claims might be processed for secondary insurances.
• Insurance Electronic Claim Submission and Response Reports are processed at least twice weekly.
• Insurance Denials, follow-ups, EDI file rejections, adjustments and aging
• Insurance Check postings
• Unapplied Credit/Refund requests for both patient and insurances
• Collections/bad debt for both patients/insurances
• Assist patients with billing questions, payments, etc. as needed via phone or in person
• Call insurance companies as needed to check on claims and patient eligibility
• Notify manager of any unresolved issues on real-time
• Help manager with assignments as needed
• Assist with coverage at Front Reception and Call Center as needed.