Medical Billing Specialist

Leavitt Family Medicine is seeking an experienced Billing Specialist to join our dynamic team. The ideal candidate must be highly motivated and have an extraordinary level of attention to detail. Should also be an experienced, self-motivated problem solver with effective communication skills while also having the ability to multitask effectively in a fast-paced environment.

Billing Specialist

Working directly with our health care providers, insurance companies and patients, you will oversee medical coding, review and submit medical claims, file and follow up on appeals, post payments, and work accounts receivable.

Responsibilities

• Oversees all medical clinic coding and billing operations including claims, payments, accounts receivable and collections.
• Responsible for coding all medical services procedures CPT, HCPCS,ICD-10 codes, ensuring that all assigned codes are supported by proper clinical documentation.
• Utilizes ICD10, CPT and HCPCS codes for reporting diagnoses and procedures.
• Maintains performance and quality by conducting ongoing audits of encounters and claims to ensure that codes are fully supported by the clinical documentation.
• Assigns all potential HEDIS-allowable codes for appropriate services to be captured.
• Ensures progress notes are coded accurately and to the highest level of specificity following established coding guidelines.
• Abstracts valid codes from hospital claims data and outpatient providers.
• Works with providers for clarification and obtaining accurate and complete documentation as needed.
• Enhances and maintains billing and coding knowledge and skills.
• Provides feedback to management regarding any billing or coding issues.
• Maintains patient confidentiality at all times, according to legal requirements and privacy laws.
• Follows established policies and procedures.
• Educates providers on all billing and coding documentation requirements.
• Reports findings of chart audits and clinical documentation improvement (CDI) opportunities to providers to optimize the coding of ongoing risk-adjusted conditions.
• Reviews and submits claims, works rejections and denials
• Posts electronic and paper payments from insurance companies and patients.
• Reconciles payments daily.
• Processes returned payments and refund requests.
• Inquires on every outstanding balance on aging report and resolves issues.
• Processes all accounts sent to outside collections.
• Identifies suboptimal patterns in provider or staff revenue cycle behaviors
• Collaborates with providers and staff on all billing and coding matters
• Conducts insurance authorizations and verification of benefits
• Performs current and retrospective health record reviews to identify gaps within the clinical documentation
• Provides initial and ongoing training on documentation requirements
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs duties with a high level of integrity and possesses a strong work ethic.
• Oversees complete medical clinic coding and billing pipeline.
• Processes all patient accounts and generates patient statements.
• Diligently works accounts receivable.
• Track and follow up on delinquent insurance collections/accounts receivable.
• Complete and process insurance claim forms.
• Process insurance collections and report results to the Practice Administrator for any required patient billing matters.
• Work with insurance providers to expedite the collection process.
• Verify accuracy of insurance claims against encounter notes.
• Process patient inquiries regarding billing and accounts.
• Prepare accounts receivables and patient collections reports.
• Perform data entry as needed.
• Respond to correspondence from third party payers as required.
• Perform other related duties as assigned, including processing telephone calls.
• Assists front office including scheduling appointments and answering telephone calls, also assists with other clinic responsibilities as needed.

Skills and Abilities:

• Must be comfortable interacting with employees, medical staff, leadership and medical providers
• Must demonstrate strong analytical skills and proficiency with Microsoft office products including Excel
• Must have strong critical thinking skills
• Ability to work independently without close supervision
• Ability to meet deadlines and prioritize responsibilities
• Strong ability to uphold organizational values, work with integrity, inspire the trust of others, and treat people with respect
• Strong HIPAA and OSHA knowledge

Insurance Company, Medical Clinic and/or EMR experience is preferred. Knowledge of government and commercial payor policies and medical billing experience is preferred.

If you are interested in joining our team, please submit resume. We are currently scheduling interviews for this position.

Job Type: Full-time

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person