Job Description

Job Description

Job Description

POSITION SUMMARY:
The Medical Billing Specialist reports to the Revenue Cycle Manager, under the direction of the Director of Revenue Cycle Operations, and is responsible for various business office tasks to ensure efficient billing, follow up, payment posting, and patient statement activities in order to maximize revenue.

SALARY: $48,900-$61,100

ESSENTIAL JOB FUNCTIONS:

Essential functions of the job include, but are not limited to, data entry, typing, filing, sorting, utilizing a computer for data entry, conducting research, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets, and Medical Billing. Communicating with others is an essential job function.

MAJOR AREAS OF RESPONSIBILITIES:

• Review billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.
• Prepare and submit clean claims to various insurance companies to include both paper and electronic.
• Extensive insurance follow-up and working knowledge of the appeals resolution process is required.
• Responsible for contacting insurance companies and navigating insurance websites in order to secure and expedite payments.
• Post insurance payments in a timely and accurate manner.
• Answer billing inquiries from patients, clerical staff and insurance companies.
• Identify and resolve patient billing complaints.
• Prepare, review, and send patient statements for Medical Center.
• Reconcile daily receivables for the Medical Center.
• Evaluate patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
• Perform various collection actions including contacting patients by phone correcting and resubmitting claims to third party payers
• Participate in educational activities and attends monthly staff meetings.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Perform other duties for Medical Center.

EDUCATION/LICENSURE:

• High school diploma, Associate’s preferred
• Medical billing certification or equivalent education on the job, formal education required.
• AAPC or other appropriate Professional Coding Certification preferred

• CPC, CPA, CPMA or relevant certification.

Knowledge, Skills, Abilities and other Qualifications :

• High school diploma and medical billing certificate required.
• Professional Coding or Auditing Certification preferred CPC, CPA, or relevant certification.
• Financial management, payment processing, and/or accounting experience, and/or formal training or certification preferred
• Three to five years of medical billing experience in a medical office setting or equivalent combination of training and experience required.
• Must have strong knowledge of CPT and ICD-10 codes and basic medical terminology skills.
• Experience with EMR (Electronic Medical Record) and medical billing software preferred.

• Epic experience is preferred.

• Knowledge of third-party operating procedures and practices, with the ability to read and process EOB’s.
• Proven record of accomplishment of exceeding goals; evidence of the ability of consistently make good decisions through a combination of analysis, experience and judgment; abilities in problem solving, project management and creative resourcefulness.

Understanding of documentation to Coding for Evaluation of revenue processes

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

ORGANIZATION INFORMATION:

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

Job Tags

Weekend work, Afternoon shift,

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