Job description

The Medical Insurance Billing Specialist is one of the most critical roles in the practice and performs the billing for transgender surgery consultation, operating room professional fees, aneshthesia, and operating room facility fees. They are responsible for billing insurance and following up all insurance claims.

Primary Job Functions:

• Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Insures claim information is complete and accurate
• Submits insurance claims to individual insurance companies electronically or via paper
• Answer patient questions on patient responsibility portions, copays, deductibles, etc
• Follows up with insurance company on unpaid or rejected claims. Resolves issue and re-submits claims
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany appeal
• Prepares patient statements for charges not covered by insurance. Insures statement are mailed on a regular basis
• Posts insurance and patient payments using medical claim billing software
• Follows HIPAA guidelines in handling patient information and PHI.
• Understands managed care authorizations and limits to coverage such as the number of visits.
• Verify patients benefits eligibility and coverage
• Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references
• Assumes accountability and responsibility for own work performance
• Observes assigned work schedule and hours
• Performs competently in new situations
• Maintains exceptional rapport with insurance carriers, fellow team members, physicians, and all personnel
• Bills accurately, honestly and legally.
• Performs duties in a professional and pleasant manner.
• Follows Clinic and ASC dress code regarding clothing, jewelry, artificial nails, and hair coverage

Secondary Job Functions:

• Performs duties as assigned in Clinic and ASC as scheduled
• Assists with answering multi-line phone system at all times
• Responsible for answering the phone line after the second ring
• May be required to perform other related duties for which qualified
• Performs all front desk duties and checks patients in and out as needed

Job Type: Full-time

Pay: $40.00 - $45.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• ICD-10: 1 year (Preferred)
• Medical billing: 1 year (Preferred)
• Insurance verification: 1 year (Preferred)

Work Location: One location

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