Medical Billing Specialist

Job Responsibilities

• Audit patient records for accuracy, supply missing information, and correct as needed 

• Communicate with patients to answer questions about their claims status, coordination of benefits or handling billing issues as needed 

• Investigate claims to ensure they comply with state laws and regulations such as those governing fraud, drug abuse, or mental illness 

• Review claims for accuracy and process payments to providers 

• Work denied claims to resolution including various stages of appeal 

• Maintain detailed records of claims activities to support audits by regulatory agencies or courts of law 

• Maintaining up-to-date knowledge of federal and state laws regarding medical claims processing, including provisions related to fraud prevention 

• Reviewing claims to determine whether they meet criteria for coverage under specific plans or policies 

 Job Requirements

• Education 

  • High School Diploma, GED or equivalent required 

  • Associates Degree in healthcare management or related field preferred 

• Experience 

  • Two years’ minimum experience in this position or a similar role required 

• Certifications & Licenses 

  • Certified Professional Coder (CPC) preferred 

 Skills Needed 

• Medical terminology 

• Attention to detail 

• Communication 

• Problem-solving 

• Comfortability using Microsoft products and learning new technologies

*Applicants will be required to submit to and successfully pass a background check and drug test.