As Medical Billing Specialist i am responsible for managing healthcare billing processes, ensuring accurate claim submissions, and handling reimbursements from insurance companies and patients. I play a crucial role in maintaining financial records and optimizing revenue cycles for medical facilities.
Key Responsibilities:
-Review and process medical claims for accuracy and compliance with insurance policies.
-Submit claims to insurance companies and follow up on unpaid or denied claims.
-Verify patient insurance coverage and benefits.
-Post payments and adjustments to patient accounts.
-Communicate with healthcare providers, insurance companies, and patients regarding billing inquiries.
-Ensure compliance with medical coding standards (CPT, ICD-10, HCPCS) and HIPAA regulations.
-Generate reports on billing activities and financial performance.
Skills & Qualifications:
Proficiency in different EHRs/EMRs
and tools such as(e.g. ECW, Tebra,Simple Practice,Office Ally, Prompt). Payer Portals such Athena, CCAH,Availity, Allura and others.
Strong knowledge of medical terminology, coding, and insurance claim procedures.
Attention to detail and accuracy in data entry.
Problem-solving skills to resolve claim rejections and denials.
Understanding of HIPAA and healthcare compliance regulations.
Excellent communication and customer service skills.
