Remedy Intelligent Staffing is currently hiring for a Medical Billing Specialist for our client in Norfolk, VA.
Hours: 8am-5pm, Monday-Friday
Pay: $16-$19 per hour based on experience
This is a Direct Hire position.
JOB SCOPE: With minimal supervision, prepares and submits patient claims to appropriate third party payers. Reviews claims to ensure that payer specific billing requirements are met. Resolves routine and complex patient billing inquiries and problems. Relies on extensive experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Follows standard procedures and pre-established guidelines to complete tasks.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Maintains annual compliance education.
- Regular and reliable attendance.
- Presents to work on time as scheduled.
- Familiarity with CPT (Current Procedural Terminology) and ICD-10 diagnosis coding
- Current knowledge of professional billing (CMS-1500)
- Experience in resolving denied, underpaid and no response claims
- Review and work monthly accounts receivable reports
- Place calls to insurance companies and utilize payer websites to resolve claims
- Collects patient documentation and charts for claim submission. Ensures claim forms are completely and accurately filled out.
- Updates and maintains patient billing data and ensures documents are current.
- Reviews patient charts for completeness. Contacts clinical staff for clarification on procedures or diagnosis and/or missing information.
- Enters charges, processes, and submits insurance claims to third party payer. Completes data entry of the charges into Management System.
- Verifies that initial claim is accepted by third party payers. Reviews reports for claim denials.
- Identifies and reports any payer trends, denial patterns, and delays to management. -Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient's records and collections.
- Responsible for maintaining current billing, coding, and office protocol files as a desk reference.
- Proactively identifies processes and procedures and develops tools to improve efficiencies.
- Other duties as requested or assigned. May perform payment responsibilities.
- Assists with pre and post audits. The various auditing duties are related to physician practice management and coding to maintain compliance with payer reimbursement policies and governmental regulations as well as Medicare/ CMS guidelines.
- Monitors progress resulting from periodic internal audits and communicates with Compliance Specialist.
- Provides physicians and staff with up-to-date coding information from reliable, accurate sources.
- Assists with implementing new coding guidelines in a timely manner within the practice.
- Keeps current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding initiatives.
- Maintains required annual CEU's.
- Establishes and maintains good working relationships with managers and members of other departments.