What are the responsibilities and job description for the Medical Biller position at Silver Pine Medical Group?
Job Title: Billing Specialist (Revised)
Job Summary: The Billing Specialist is responsible for preparing, submitting, and following up on claims to ensure accurate and timely reimbursement from insurance companies, government programs, and patients. This role plays a critical part in the financial cycle of healthcare delivery by managing the billing process from claim creation to payment resolution.
Job Responsibilities/Tasks:
- Keys charge information into entry program and produces billing.
- Assists in the processing of insurance claims including Medicare, HMO and Commercial claims
- Follow up on unpaid claims within standard billing cycle time frame.
- Resolve billing issues and resubmit denied or rejected claims.
- Work closely with patients to explain charges, set up payment plans, and collect outstanding balances.
- Verify insurance benefits and eligibility as needed.
- Stay updated on payer regulations, coding guidelines, and billing best practices.
- Collaborate with clinical documentation specialist, front desk, communication center and clinical staff to resolve discrepancies and improve claim accuracy.
The jobholder must demonstrate current competencies applicable to the job position.
Required Skills/Abilities:
- Strong attention to detail and organizational skills.
- Knowledge of insurance guidelines including Medicare, Medicaid, and commercial carriers.
- Excellent communication and customer service skills.
- Ability to work independently and handle multiple tasks.
Education:
- High school diploma or equivalent required.
- Certificate or coursework in medical billing, healthcare administration, or a related field preferred.
Experience:
- Minimum of 3 years of medical billing experience preferred.
- Familiarity with CPT, ICD-10, and HCPCS coding systems.
- Experience with electronic health records (EHR) and billing software.
Work Environment: Billing Department Area. Exposure to communicable diseases and other conditions related to clinic setting. Work may be stressful due to a busy office.
Mental/Physical Requirements: Ability to work in a fast-paced environment. Ability to sit for extended periods of time. Ability to respond professionally and calmly in all situations. Ability to handle interruptions. Ability to maintain a clean, organized, friendly work environment. Punctual and flexible with schedule and duties as needs arise. Ability to work closely with a cohesive team spirit with a positive attitude.