Medical Billing Specialist

Responsibilities

• Affirms compliance with HIPAA, PHI regulatory, and related policies and practices.
• Reports any Compliance issues to the Director of Operations.
• Captures the insurance verification process and ensures clients understand their co-pay responsibilities.
• Follows up to facilitate the collection of co-pays when applicable.
• Gathers and processes payment information from clients and enters it into the system.
• Enters and updates client information into the computer system promptly and contacts referral sources, customers, and clients to obtain missing information.
• Ensures accuracy and completeness of data.
• Confirms sales orders in the system and verifies all required information before submitting claims for payment.
• Follows up on missing sales orders and resolves billing questions regularly until payment status is complete.
• Timely submits claims (both electronic and paper as needed) to payers and corrects and resubmits rejected claims.
• Posts cash transactions to the correct accounts in a timely manner.
• Timely follows up and collects payments owed to the organization.
• Generates invoices and/or follows up with clients and/or payers to resolve inquiries.
• Maintains knowledge of current regulatory guidelines and reimbursement information to ensure appropriate billing and reimbursement.
• Performs other duties and projects as assigned by management, including customer service support.

Qualifications

High school diploma or equivalent required. Bachelor's degree in healthcare, business, or a related field preferred. Minimum of 2 years of experience in medical billing or a related field. Knowledge of HIPAA, PHI regulations, and related policies. Proficiency in using medical billing software. Strong organizational and communication skills. Ability to work independently and manage multiple tasks simultaneously.

Skills

• Knowledge of HIPAA, PHI regulations, and related policies.
• Proficiency in medical billing software.
• Strong organizational and communication skills.
• Ability to work independently and manage multiple tasks.

Benefits

• Medical and Prescription Drug Plans
• Dental Plan
• Vision Plan
• Health Savings Account (for High-Deductible Health Plans)
• Flexible Spending Accounts (Health, Limited Purpose, Dependent Care, Commuter Parking and Commuter Transit)
• Supplemental Life Insurance
• Short Term Disability (coverage varies by state)
• Long Term Disability
• Critical Illness, Hospital coverage, Accident Insurance
• MetLife Legal, MetLife ID Fraud, and MetLife Pet Insurance
• 401(k)