3 medicare medical billing specialist Jobs in plano, tx
CommunityMed Urgent Care is Hiring a Medical Billing Specialist Near Plano, TX
- Experience in outpatient billing – Family, Internal, General, Urgent Care, etc.
- Big plus if knowledgeable in Advanced MD billing software
- CMS 1500 Claim form processing is a must
- Experience with both Commercial and Government insurance and Worker’s Comp
- Ability to properly assign claims to either (1) Family Practice contracts or (2) Urgent Care contracts and ready them for proper submission according to payor guidelines
- Coding certification is a plus (CMC, CPC, CCC, CCS, etc.)
- Experience with NCCI edits
- We use a unique tailored system (DANNY) to do an initial pre-scrub of the PV charts, import that pre-scrubbed data into Advanced MD where work is put in 1 of 4 buckets:
- (1) Chart review, (2) Inspector, (3) Exclusion, and (4) Unbilled
- These buckets are where work is assigned and executed.
- We have contracts in place to bill for (1) Family Practice and/or (2) Urgent Care services
- Candidates should be knowledge in billing/revenue cycle for relatable claims – General Medicine, Internal Medicine, Urgent Care, or other similar outpatient billing services
- CMS 1500 claim form experience is a must
- 2-5 years of experience in outpatient billing and collections
- Working knowledge of NCCI editing
- Knowledge of Commercial and Government payor and Worker’s Comp guidelines
- Proficient in medical terminology, HIPAA, and other critical governmental regulations
- Organized, detail-oriented, and ability to meet deadlines
- Ability to comprehend various insurance documentation, analyze and reconcile accounts and follow detailed procedures in an organized and efficient manner
- Strong computer skills (Word, Excel, billing software)
- Perform billing for all Commercial, Medicare or Worker’s Comp claims
- Identify and resolve rejections for claims
- Determine root cause(s) that resulted in the rejected claim (i.e., 2 primary insurances, wrong demographic info, missing documentation, incorrect modifier, etc.)
- Resolve issues and recommend procedural changes to prevent further rejections
- Resubmit/refile claims and appeal rejected claims as necessary
- Ability to explain EOBs regarding patient’s insurance benefits for the requested service and ability to provide supporting documentation as needed (i.e., fee schedule, contractual obligations, deductible status of plan, etc.)
- Maintain current documentation related to the patient’s claims, denial and appeals.
- Refer complex issues to the supervisor for review and or action.
- Adhere to contractual requirements of Medicare, and managed care plans
- Ensure a continuous quality improvement customer service approach by proactively identifying areas of improvement and communicating those ideas to the healthcare team.
- Cross-trains in collections to research rejected claims, communicate denied claims, and adhere to contractual requirements of Medicare and managed care plans
- Should be able to handle incoming patient calls regarding to account status and outstanding balances
- Biller production levels: with a focus on charge entry, up to 500 claims/daily after initial 30-60 days
- Ability to read and write English (legibly)
- Ability to communicate appropriately and effectively
- Ability to understand and resolve simple to complex problems
- Ability to understand simple to complex instructions
- Ability to frequently utilize full range of motion, including crouching, stooping, reaching, bending, and twisting
- Ability to prioritize and handle multiple tasks
- Ability to function independently without constant supervision
Job Summary
Full Time
$40k-47k (estimate)
01/27/2024
06/18/2024
The job skills required for Medical Billing Specialist include Billing, Medical Billing, Customer Service, Billing Software, HIPAA, etc. Having related job skills and expertise will give you an advantage when applying to be a Medical Billing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Medical Billing Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Medical Billing Specialist positions, which can be used as a reference in future career path planning. As a Medical Billing Specialist, it can be promoted into senior positions as a Medical Billing Supervisor that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Medical Billing Specialist. You can explore the career advancement for a Medical Billing Specialist below and select your interested title to get hiring information.
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