Medical Billing Specialist

Job description

Revenue Cycle Management is looking for a full-time Medical Billing Specialist to join our team!

Hybrid opportunity after 90 days of in-person training (2 days from home, 3 days in office)

SUMMARY: The Medical Billing Specialist is responsible for analyzing patient's records and coding the patient's records based on ICD-10 and CPT codes. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections.

ESSENTIAL FUNCTIONS:

Reviews patient accounts and supporting documentation to ensure all billable services and charges are captured accurately

Validates diagnosis and procedure codes on accounts for billing accuracy and payer requirements; escalates discrepancies for correction

Communicates with clinical, coding, and front-end teams to obtain or clarify missing or incomplete information

Prepares and submits accurate electronic and paper claims to commercial insurance carriers and government payers

Investigates and resolves claim denials and rejections, including appropriate corrections and resubmissions

Maintains accurate and up-to-date patient account information within the electronic medical record (EMR) and billing systems

Identifies trends or recurring issues impacting reimbursement and communicates findings to leadership

Ensures compliance with payer guidelines, company policies, and applicable regulations

Perform other related tasks as needed

KNOWLEDGE, SKILLS, AND ABILITIES: Knowledge of medical billing processes, including insurance verification, prior authorization, patient responsibility, and workers' compensation

Knowledge of explanation of benefits (EOBs), remittance advice, and coordination of benefits (COB) processing

Working knowledge of medical terminology and ICD-10, CPT, and HCPCS coding systems as they relate to billing accuracy

Knowledge of payer guidelines, including government and commercial insurance requirements, claims submission, and denial management

Proficient in electronic billing systems and claim forms, including HCFA Form CMS-1500

Experience with electronic medical records (EMR) and practice management systems

Strong analytical and problem-solving skills with the ability to identify and resolve billing discrepancies

High attention to detail and accuracy in reviewing and processing claims

Strong organizational and time management skills with the ability to prioritize tasks effectively

Ability to work independently with minimal supervision and adapt to changing priorities

Effective written and verbal communication skills, including the ability to communicate professionally with internal teams and external parties

Proficient in Microsoft Office applications, including Word, Excel, and PowerPoint

EDUCATION AND EXPERIENCE: High School Diploma or GED

Three (3) years of experience with medical billing, accounts receivable, or revenue cycle operations

Medical billing certification in lieu of experience

BENEFITS: 3 Medical Plans

2 Dental Plans

2 Vision Plans

Employee Assistant Program

Short- and Long-Term Disability Insurance

Accidental Death & Dismemberment Plan

401(k) with a 2-year vesting

PTO + Holidays

Please visit our website for more information:

Premier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment for this position is contingent upon the successful completion of a background check and drug screening.

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.