Medical Billing Specialist - Remote

About the role

The Medical Billing Specialist processes and transmits claims, tracks claim status, verifies payor benefits and eligibility, manages collections, and posts cash receipts.

Responsibilities

• Extract and verify billing information from medical records
• Ensure collection of past-due balances; follow up as needed
• Verify patient demographic and insurance data before submitting claims
• Answer patient account inquiries and establish alternative payment plans when necessary
• Maintain patient account records and resolve third-party payer issues
• Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)
• Prepare and review patient statements prior to release through PMS
• Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims
• Balance daily charges and reconcile with reports within PMS
• Collaborate with revenue cycle manager and payers on denials and rejections
• Work closely with practice representatives to ensure proper insurance verifications and authorizations
• Other duties as assigned

Requirements

• Comply with applicable legal requirements, standards, policies, and procedures, including Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act
• Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
• Communicate professionally with patients and guarantors regarding balances or account information
• Participate in required orientation and training programs
• Cooperate with monitoring, audit functions, and investigations
• Participate in process improvement responsibilities
• Meet productivity goals
• Handle multiple priorities effectively
• Successful completion of required training

Skills

• Problem-solving skills to manage a variety of concrete variables
• Effective verbal and written communication skills
• Ability to interpret instruction presented in a variety of situations
• Strong organizational skills; ability to manage multiple projects simultaneously
• Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
• Ten-key speed and accuracy