The Medical Billing Specialist is responsible for managing patient accounts receivable through payer collection efforts.
Essential Job Functions
Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI) or other sensitive and personal information.
Compiles, sorts, and verifies accuracy of claim data to be entered into billing system.
Runs insurance A/R reports and calls carriers regarding status of outstanding claims, enters appropriate claim follow up notes on patient accounts in PM system.
Follows up and resolves payer rejections, denials and reduced payments.
Secures needed medical documentation required or requested by third party insurances.
Prepares and submits hard copy claims to third-party insurance carriers when necessary.
Verifies patient insurance for scheduled visits ahead of time, if needed.
Assists Patient Accounts Specialist with patient phone calls when requested.
Reads and analyzes clearinghouse reports as directed.
Follows up on insurance denials and takes appropriate steps to resolve discrepancies.
Communicates discrepancies and the need for additional information to the appropriate parties.
Keeps supervisor apprised of matters regarding billing system or payer issues causing claim denials or rejections.
High School graduate (or GED) required.
5+ years of medical billing experience in a health care organization required.