We are seeking an experienced and detail-oriented Medical Billing Specialist to join our dynamic revenue cycle startup. The ideal candidate will have a background in healthcare revenue cycle management, possess analytical skills, and be adept at utilizing data to drive strategic decision-making. The Medical Billing Specialist will play a crucial role in optimizing revenue performance, identifying process improvement opportunities, and ensuring the clients revenue cycle management’s health.

Responsibilities:

1. Claims Processing: Prepare and submit medical claims to insurance companies or government programs for reimbursement.

2. Coding Verification: Ensure accuracy of medical codes and patient information on claims to comply with billing regulations.

3. Payment Posting: Record and reconcile payments received from insurance companies, patients, or other third-party payers.

4. Denial Management: Investigate and appeal denied claims, identifying reasons for rejection and taking appropriate actions for resolution.

5. Patient Billing: Generate and send invoices to patients for services rendered, explaining charges and assisting with payment inquiries.

6. Insurance Verification: Verify patient insurance coverage and eligibility prior to services being rendered.

7. Follow-up: Conduct follow-up with insurance companies, patients, or healthcare providers to resolve billing discrepancies or outstanding balances.

8. Compliance: Adhere to HIPAA regulations and other industry standards to maintain patient confidentiality and data integrity.

9. Documentation: Maintain accurate records of billing activities, including claims submissions, payments received, and communications with payers.

Qualifications:

1. Certification in AAPC, AHIMA, (preferred), knowledge of code data sets to include CPT, HCPCS, and ICD-10, NCCI edits, and Medicare LCD/NCDs.

2. High school diploma or equivalent required; additional education in medical billing and coding preferred.

3. Previous experience in medical billing, preferably in a healthcare setting, is desirable.

4. Proficiency in medical terminology, ICD-10 and CPT coding, and insurance billing procedures.

5. Strong attention to detail is crucial to ensure accuracy in coding and billing processes.

6. Effective written and verbal communication skills are essential for interacting with insurance companies, patients, and healthcare providers.

7. Familiarity with medical billing software and electronic health records (EHR) systems is beneficial.

8. Ability to analyze billing data, identify trends, and troubleshoot billing issues.

9. Collaborative attitude and ability to work effectively as part of a healthcare team.

10. Willingness to adapt to changes in billing regulations, technology, and healthcare industry standards.

Job Types: Full-time, Part-time

Pay: $21.50 - $22.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• Choose your own hours
• Monday to Friday

Work setting:

• Remote

Work Location: Remote