Job Title: Medical Billing Operations Specialist
Reports To: Operations Director
Employment Status: Full-Time
FLSA Status: Non-Exempt
Job Summary:
We are seeking a highly motivated and detail-oriented Medical Billing Office Operations Specialist to join our dynamic team. The ideal candidate will have a strong understanding of medical billing procedures, coding, insurance claims, and excellent customer service skills. This position will be responsible for ensuring accurate and efficient billing operations.
Duties/Responsibilities:
- Processes and submits insurance claims in a timely manner.
- Verifies insurance coverage and benefits, initiates pre-authorizations, and handles pre-certification of procedures.
- Utilizes ICD-10, CPT, and HCPCS coding systems accurately.
- Reviews medical records to ensure accurate coding and billing practices.
- Follows up on unpaid claims and manages denials by conducting investigations and filing appeals.
- Maintains strict confidentiality in accordance with HIPAA guidelines.
- Resolves patient inquiries and complaints related to billing.
- Documents billing procedures and maintains patient billing records.
- Generates and reviews financial and billing reports.
- Provides training and guidance to other billing staff as required.
- Stays updated with the latest insurance and healthcare regulations.
- All other duties as assigned.
Required Skills/Abilities:
- Excellent organizational and multi-tasking skills, with a keen eye for detail.
- Strong problem-solving abilities and analytical skills.
- Outstanding written and verbal communication skills.
- Proficiency in data entry and basic office software applications.
Education and Experience:
- High school diploma or equivalent required.
- Minimum of 2 years of experience in a medical billing or similar role.
- Proficiency in medical billing software and electronic health records (EHR).
- In-depth knowledge of insurance processes, including verification, pre-authorization, and claims appeal procedures.
Benefits
- 401(k) plan with matching contributions