Description

The Medical Billing and Collections Specialist will be responsible for medical billing and collections of either governmental or non-governmental claims to third party payors. The Medical Billing and Collections Specialist will be capable of reviewing and troubleshooting claims within the billing system to correct errors, edits, or nuances preventing a bill from going to the payer. The Billing and Collections Specialist will be responsible for contacting patients regarding account balances. The Billing and Collections Specialist will Resolve pending healthcare claims, prior approval requests and responding to providers; Analyze claims to determine whether or not the claims should be approved or denied for payment; Monitor daily collections, outstanding claims, AR Aging and Dashboard; Identify and report trends; Prioritize workload, fix errors and follow up where necessary; Review write-offs and other revenue cycle duties as required.

Requirements

• High School Diploma or equivalent
• CPC, COSC, COC, CCS, or CCS-P through AAPC of AHIMA preferred
• Must have 3-5 years of active medical billing and collections experience
• Preferred experience in orthopedics and pain management 
• Experience with Epic preferred
• Advance knowledge of medical terminology, anatomy and physiology, disease process, pharmacology, and complex surgical procedures. 
• Advance knowledge of ICD-10-CM, CPT, HCPCS, CCI, MUE, NCD, and payment modifiers.
• Advance knowledge of information systems, encoders, and other technology to facilitate a successful virtual work environment 
• Experience with Microsoft Office Suite
• Must be well organized, detail-oriented, and able to multi-task.
• Must be able to work independently.
• Excellent verbal and written communication skill