Medical Billing Specialist

Job Overview
As a member of the RCM Team, the Medical Billing Specialist, will need to be highly motivated and detail-oriented to meet metrics related to RCM billing process for Professional Services, ensuring accurate and timely submission of claims, working A/R and optimizing revenue cycle operations.

Qualified candidates must be committed to exceed expectations through continuous staff training and engagement, surpassing metrics and contribute to the overall operational success. The following is a brief overview for this Role:

• Prepare and submit accurate medical claims, adhering to insurance guidelines and coding standards related to Professional Services.
• Review as needed, medical records to verify diagnosis codes (ICD-9, ICD-10) and procedure codes (CPT coding), ensuring proper documentation for billing purposes.
• Follow up on unpaid or denied claims through medical collection efforts, resubmitting or appealing as necessary to maximize revenue.
• Maintain comprehensive records of billing activities, claim status updates, and payment histories for audit readiness.
• Stay current with industry changes in ICD coding updates, CPT guidelines, and insurance policies to ensure compliance and accuracy.

Qualifications

• Proven experience in medical billing with a solid understanding of medical terminology, medical records management, and coding practices.
• Familiarity with ICD-9, ICD-10, CPT coding.
• Strong knowledge of medical office procedures and proficiency with EMR/EHR systems.
• Excellent attention to detail with the ability to review complex medical documentation accurately.
• Ability to communicate effectively with insurance companies, healthcare providers, and patients regarding billing inquiries.
• Knowledge of medical collection processes and strategies for improving payment recovery.
• Prior experience working with medical coding standards and insurance claim submission protocols is highly preferred.

Pay: $20.00 - $23.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person