MEDICAL BILLING SPECIALIST
Databand Consultants Limited
Accounting, Auditing & Finance
Job Summary
The Medical Billing Specialist is responsible for managing the entire billing process, ensuring accurate submission of claims and maximizing reimbursements from insurance companies and patients. This role involves verifying patient information, coding medical procedures, submitting claims, and resolving billing discrepancies. The ideal candidate possesses extensive knowledge of medical billing, insurance policies, and healthcare reimbursement systems, with the ability to work independently in a fast-paced environment. A bachelor's degree is required for this role to ensure a deep understanding of healthcare administration and revenue cycle management.
- Minimum Qualification : Bachelors
- Experience Level : Mid level
- Experience Length : 2 years
Job Description/Requirements
- Accurately process and submit medical claims using proper coding
- Review and verify patient information, insurance eligibility, and coverage.
- Submit and track claims to insurance companies and third-party payers.
- Follow up on unpaid or denied claims, resolving billing issues and discrepancies promptly.
- Work closely with the coding department to ensure accurate and compliant claims submissions.
- Assist patients by explaining billing processes, payment options, and account balances.
- Process patient payments and insurance payments and apply them to the appropriate accounts.
- Handle appeals and re-submissions for denied or underpaid claims.
- Maintain accurate records of billing transactions, payment postings, and account adjustments.
- Generate and analyze reports on billing, collections, and accounts receivable to ensure revenue optimization.
- Collaborate with providers, insurance representatives, and billing staff to streamline the billing process and resolve issues.
- Stay up-to-date with changes in insurance policies, coding requirements, and healthcare regulations.
Qualifications:
- Bachelor’s degree in Healthcare Administration, Health Information Management, Accounting, or a related field required.
- Knowledge of ICD-10, CPT, and HCPCS coding systems, as well as healthcare reimbursement practices.
- Strong understanding of insurance claims processing and healthcare regulations.
- Excellent communication, organizational, and problem-solving skills.
- Ability to work independently with attention to detail in a high-volume setting.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
Education & Experience:
- Bachelor’s degree in Healthcare Administration, Health Information Management, or a related field required.
- A minimum of 2-3 years of experience in medical billing, coding, or healthcare revenue cycle management.
Key Responsibilities:
Accurately process and submit medical claims using proper coding
Review and verify patient information, insurance eligibility, and coverage.
Submit and track claims to insurance companies and third-party payers.
Follow up on unpaid or denied claims, resolving billing issues and discrepancies promptly.
Work closely with the coding department to ensure accurate and compliant claims submissions.
Assist patients by explaining billing processes, payment options, and account balances.
Process patient payments and insurance payments and apply them to the appropriate accounts.
Handle appeals and re-submissions for denied or underpaid claims.
Maintain accurate records of billing transactions, payment postings, and account adjustments.
Generate and analyze reports on billing, collections, and accounts receivable to ensure revenue optimization.
Collaborate with providers, insurance representatives, and billing staff to streamline the billing process and resolve issues.
Stay up-to-date with changes in insurance policies, coding requirements, and healthcare regulations.
Qualifications:
- Bachelor’s degree in Healthcare Administration, Health Information Management, Accounting, or a related field required.
- Knowledge of ICD-10, CPT, and HCPCS coding systems, as well as healthcare reimbursement practices.
- Strong understanding of insurance claims processing and healthcare regulations.
- Excellent communication, organizational, and problem-solving skills.
- Ability to work independently with attention to detail in a high-volume setting.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
Education & Experience:
- Bachelor’s degree in Healthcare Administration, Health Information Management, or a related field required.
- A minimum of 2-3 years of experience in medical billing, coding, or healthcare revenue cycle management.
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