Medical Billing Specialist

Duties and Responsibilities

• Independently review and process coding corrections, payer rules, and documentation requirements identified by the RCx Coding Application.
• Submit prior authorizations across a mix of payers, ensuring timely follow up and documentation.
• Provide comprehensive and timely surgery estimates to patients; proactively clarify benefit discrepancies when needed.
• Manage assigned A/R worklists, including claim corrections, resubmissions, and denial follow-up.
• Research insurance overpayments, initiate refund workflows, and provide supporting documentation.
• Serve as a primary responder for the Billing Phone Line and Billing Inbox.
• Provide technical support to internal customers through the Billing Help Desk.
• Participate and contribute to departmental workshops and project days.

Qualifications

• 1–2 years of experience in medical billing or revenue cycle management required.
• Proficient understanding of coding principles, payer billing guidelines, and authorization processes.
• Strong problem-solving abilities and excellent communication skills.
• Effective time management with exceptional attention to detail.
• Demonstrated analytical thinking and sound judgment.
• Commitment to the mission and values of Vanguard Skin Specialists.

Benefits

• Compensation: $20.00-$22.75 an hour (based on experience).
• Eligibility for overtime and paid time off.
• Coverage for a portion of the premium for medical benefits.
• Offers vision, dental, and 401K.
• Paid Time Off, Graduate School Stipend, bereavement pay, Paid Maternity & Bonding Leave, Employee Discounts on products and aesthetic services.

Physical Working Conditions

• Must be able to remain in a stationary position 90%.
• The other 10% occasionally move about inside the office to access file cabinets, office printer, etc.
• Operate a computer and other office machinery, such as a calculator, printer, copier, scanner, or fax.
• Be able to communicate accurately, effectively, and frequently.
• Can identify color on the computer and software used.