Medical Billing Specialist 1
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Description
About Us
Our physicians offer a full scope of occupational medicine services designed to help reduce healthcare costs, while minimizing lost work time and increasing employee productivity. To accomplish these goals, Akeso is outcome focused and provides medical care on an urgent or appointment basis for occupational injuries and illnesses. We also design modified work and rehabilitation programs to enable injured employees to return to work as soon as possible.
Summary /Objective
The Medical Billing Specialist is responsible for invoicing patient visits, ensuring accuracy and compliance for healthcare professional Workers’ Comp claims. Maintains databases and audits patient’s chart and billing information for accurate processing of claims. Analyze, identify and resolve billing issues causing payment delays. Research and resolve patient, providers and insurance companies concerns in a timely manner. Must have experience in billing with claim follow ups, checking the status for unpaid claims, submitting corrected claims, and filing appeals.
Requirements
Essential Functions
- Invoices all visit orders for multiple clinics in a timely manner.
- Obtains claim numbers and adjuster contact information promptly and updates medical records.
- Accurately routes bills to either the employer or WC carrier.
- Communicates effectively with carriers to submit necessary documentation for payment of claim.
- Review practitioner documentation and perform audits to determine accuracy and gaps.
- Responsible for documenting all correspondence with insurance, client, and / or insurance to record.
- Comply with all applicable HIPAA policies and procedures.
- Prepares and sends Medical Record to insurance.
- Communicates effectively with carriers to submit what is necessary for payment.
- Verify completeness and accuracy of all chart documents and orders prior to submission.
- Collaborate with other departments to obtain and analyze additional information about patients to be able to record and process billing effectively.
- Assists with assigned projects that pertain to billing under the direction of the Billing and Collections Manger.
Competencies
- Excellent Customer Service
- Problem-Solving Skills
- Detail Oriented
- Strong written and verbal communication skills
- Collaboration Skills
- Ethical Conduct
- Thoroughness
Education/Experience/Skills:
• Minimum 2 years’ experience specifically in Medical Billing required, preferable experience
in coding and billing
• Extensive knowledge of ICD-10 and CPT codes
• Extensive knowledge of procedure modifiers
• Knowledge of basic office equipment such as scanners, electronic faxing, iPad, copy
machines, etc.
Preferred Qualifications:
• Certification in Medical Billing and Coding
• Knowledge of Medical terminology
• Experience in Worker’s Comp
Work Environment
This job operates in a clerical, office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
This is a largely sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. Evening and weekend work may be required as job duties demand.