The Medical Billing Specialist is responsible for managing all patient and insurance billings in a timely and efficient manner. This includes, but is not limited to, charge entry, payment entry, accounts receivable management, and responding to patients and payers and special projects as assigned.

RESPONSBILITIES OF MEDICAL BILLING SPECIALIST

• Responds to phone calls and works effectively with patients regarding billing procedures, balances, statements and establishing payment plans.
• Research information concerning write-offs / adjustments and makes recommendations to the Manager for resolution.
• Accurately codes charges using generally accepted coding rules for diagnosis and procedure and enters the patient management system within 1 business day from the service date.
• Accurately processes insurance payments and electronic remittance files and reconciles to patient accounts within 1 day from deposit date. Reviews denials and initiates corrective action daily. Manages the lock box payments and balances payments to the deposit daily.
• Processes electronic and paper claims and submits to payer or clearinghouse with necessary attachments and documentation to support the claim.
• Maintains account receivables by following up on outstanding claims.
• Researches all information needed to complete the billing process to include getting charge information from Physicians/Nurse Practitioners/Physician Assistants.
• Maintains documentation and reporting for all activities as reported by policy and law.
• Accurately tracks and records data required from the medical offices, payers, and Management.
• Completes processes and reporting related to the EOD or EOM period close as assigned.
• Processes outgoing mail for the organization and incoming mail for administration.
• Manages incoming calls, transfers voice mail for administration.

REQUIREMENTS FOR MEDICAL BILLING SPECIALIST

• Minimum 3 years’ experience in a related field.
• Associate degree in a related field is preferred.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Proficient skills in Microsoft Word, Microsoft Outlook, text paging, and Internet and Intranet research.