Medical Billing/ Coding Specialist

Job Description

Job Timings: 09:30 PM-05:30 AM



-Monitor Insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing.


-Working knowledge of CPT and ICD-9 and 10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal process.


-Ability to stay aware of billing/submission delay issues (encounters not closed/items not being billed/more accurate coding to use for increased revenue)


-Ability to learn all office programs and foster relationships with vendors in order to provide timely daily/weekly/monthly/quarterly/yearly reports as requested/needed


-Work with providers to correct the diagnosis or procedure codes so that the claim can be processed.


-Respond to and process insurance claim disputes.


-Knowledge of electronic billing systems 


-Coordinate insurance reimbursement of care providers


-Ability to work with staff to assist with referral/auths needed to ensure payment of procedures


-Researches and processes refund requests and overpayments.


-Generates and submits electronic claims and corrects any errors for complete and accurate transmission of data.


-Knowledge of medical terminology.


-Use of online reference data base services.


-Attention to detail, able to prioritize workload.


-Strong organizational and planning skills.


-Excellent written and verbal communications skills.


-Proficiency in MS Office and Patient Management software.


Preferred Experience:


-Revenue Cycle Management (RCM) Experience 

-Certified Professional Coder (CPC)

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