JOB SUMMARY:

The medical billing and collection specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, and posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess critical thinking skills and an understanding of Medicare, and Medicaid eligibility requirements, as well as commercial insurance payer payment methods, to correctly record contractual adjustments, based on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with the billing system to ensure all functionality is utilized for the utmost efficient processing of claims.

MAJOR DUTIES & RESPONSIBILITIES:

• Responsible for correcting, completing, and processing claims for all payer codes
• Analyze and interpret that claims are accurately sent to insurance companies
• Perform follow-up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports
• Able to identify an appeals-worthy claim and or ability to process appeals online or via paper submission; Assist with billing audit-related information
• Attend provider meetings/ workshops when needed
• Communicate with the billing and credentialing coordinator to identify and resolve audit review issues
• Answer/respond to correspondence related to patient accounts. Is available to answer billing and related inquiries by patients
• Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or Supervisor
• Maintain patient confidence and protects medical office operations by keeping patient information confidential
• Contribute to team effort by accomplishing related results as needed
• Perform other duties as assigned to support National Billing's Mission, Vision, and Values.

EDUCATION:

• High school or equivalent

EXPERIENCE:

• ICD-10: 1 year (Preferred)
• Medical Billing, Coding, Appeals, or Records: 1 year (Preferred)

LANGUAGE SKILLS:

• Ability to read, analyze, and interpret general health and social services guidelines, technical procedures, or governmental regulations.