Billing Specialist

Join Our Team as a Billing Specialist at PRMA!

Are you a detail-oriented, experienced medical billing professional ready to make a significant impact in a thriving healthcare environment? PRMA is seeking a Billing Specialist to manage and streamline billing processes for our surgeons, ensuring accuracy, efficiency, and compliance with insurance guidelines.

In this role, you’ll work closely with our Revenue Cycle Manager and collaborate with various departments to process claims, manage payments, and resolve billing issues. Your expertise will help PRMA maintain its high standards of patient care while ensuring smooth revenue cycle operations.

If you have a strong background in medical billing, excellent communication skills, and thrive in a collaborative, fast-paced environment, we’d love to hear from you!

Why Join PRMA?

• Work with a compassionate, professional team dedicated to providing top-quality patient care.
• Gain experience with cutting-edge systems like MOMS AT, MODMED and Nextgen.
• Enjoy a collaborative work environment where your expertise and initiative are valued.

Apply now to bring your billing expertise to PRMA and be part of our dedicated team!

Position Title: Billing Specialist

Immediate Supervisor: Revenue Cycle Manager (RCM)

Position Summary: The Billing Specialist is responsible for all aspects of billing for the assigned surgeons while following departmental processes, policies and protocols.

Responsibilities:

All responsibilities and duties relate to the billing specialist’s assigned surgeon(s) unless otherwise specified.

Answer department calls from office staff, insurances and patients. Voicemails and emails are to be returned within 24 hours.

Communicate and assist Billing Team and other departments as needed within PRMA.

Comply with legislative changes regarding all commercial and government insurance carriers.

Print and read operative and procedure reports from the hospital portals and/or Nextgen. Enter charges into MOMSAT & MODMED per the specific insurance contract taking into account all coding rules, insurance guidelines and departmental protocol.

Mark completed surgeries as 'kept' in Nextgen and add appropriate Global Alert.

Post insurance and patient payments into MOMSAT & MODMED systems as received. Update collection alerts in Nextgen when necessary.

Validate and refer all patient refunds to Revenue Cycle Manager and/or CFO for processing.

Validate and appeal incorrectly processed insurance claims and/or denials per the insurance policy.

Respond to insurance requests for medical records in a timely manner. Notate MOMSAT & MODMED per the particular claim the request corresponds to.

Enter new insurance carriers into MOMSAT, MODMED and Nextgen.

Update patient demographics and insurances as needed.

Calculate and notate patient responsibilities in MOMSAT, MODMED and Nextgen systems, as well as advise patients of upcoming financial liabilities via email, mail or phone.

Arrange payment plans and/or assist with financial assistance grants with patients as necessary.

Review patient balances each mid-month, making contact with patients who have delinquencies.

Following departmental rotation, every Thursday, print, review and reverify insurance benefits, eligibility and authorizations for all preoperative appointments with scheduled surgeries and office procedures. Notify patients of any increased financial responsibilities. Communicate issues to appropriate department.

Maintain communication with all departments regarding any abnormal patient insurance/scheduling conflicts. Follow through until the resolution is complete.

Verify surgical benefits and enter into Nextgen chart for all scheduled surgeries and office procedures.

Print and review the daily appointment schedule to verify all preoperative and office procedure appointments have been notated and/or updated collection notes.

Complete tasks and projects as assigned by RCM or Administrator.

Job Type: Full-time

Pay: $18.00 - $24.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Retirement plan
• Vision insurance

Application Question(s):

• Do you have experience with MOMS AT System, MODMED and Nextgen EMR?

Education:

• High school or equivalent (Required)

Experience:

• Medical billing: 2 years (Required)

Language:

• Spanish (Preferred)

Ability to Commute:

• San Antonio, TX 78240 (Required)

Work Location: In person