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Medical Billing Specialist
The Medical Billing Specialist is in charge of calculating and collecting payments for medical, dental and behavioral health procedures and services.
- High school degree or equivalent, college course work in the medical field preferred
- Experience in health care billing required
- Ability to read and understand ERAs and EOBs required
- Knowledge of CPT and ICD-10 coding a plus
- Experience using an Electronic Health Record software is highly desired
- Demonstrated excellent written and verbal communication skills
- Ability to multi-task, prioritize projects and meet deadlines
Duties & Responsibilities:
- Performs a comprehensive review of health record documentation, superbill and other reporting tools to identify all services and procedures performed by providers performing clinical services.
- Assigns appropriate CPT-4 and HCPCS Level II procedure codes (and modifiers as needed), according to established guidelines.
- Assigns appropriate ICD-10CM diagnosis codes selecting the codes that accurately describe the documented condition for which the service or procedure was performed, according to established guidelines.
- Assures the final diagnosis and procedures as stated by the physician are valid and complete
- Post payments received via EFT or by paper check to patient accounts daily
- Analysis of income documentation in order to calculate slide fee eligibility
- Prepares electronic claims for submission to the appropriate payer.
- Obtains and submits copies of medical documentation as required or requested by third party payers.
- Analyzes and resolves claim rejections and denials related to coding issues.
- Identifies trends and ongoing problems related to medical documentation and recommends possible solutions
- Answers patient questions, identifies and resolves patient billing complaints
- Monitors and evaluates both patient balances and insurance balances in the accounts receivable
- Ensures strict confidentiality of financial records adhering to established HIPAA guidelines and regulations as well as clinic policies and procedures.
- Compiles monthly reports as requested by clinic management
- Supports office staff members as required
- Other duties as requested by supervisor.
- Ability to function effectively as a team member.
- Complex problem solving skills;
- Ability to manage multiple projects;
- Working knowledge of medical office billing and electronic submission
- Knowledge of Medical terminology
- High level accuracy and attention to detail
- Ability to prioritize heavy workloads & multiple tasks with different deadlines
- Excellent verbal and written communication skills;
- Skilled in use of Microsoft office products, Outlook email system and other data base software.
- Knowledge of health care and practice with diverse populations and cultures.
Physical Demands/Working Conditions:
- This position may be exposed to virus, disease and infection from patients in working environment
- While performing the duties of this job, the employee is regularly required to identify, communicate and exchange information
- The employee regularly is required to move about the building
- Employee may regularly have to lift up to ten pounds
The above information is intended to describe the most important aspects of the job. This job description is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required in order to perform the work. Duties, responsibilities and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. The Kansas City CARE Clinic is committed to providing equal employment opportunity/affirmative action (EEO/AA) to all job applicants and employees.
Job Type: Full Time