Medical Billing Specialist – Claims Follow up Specialist

We are looking for a full-time, highly detailed, accurate, and motivated Medical Billing Specialist to help the company in our claims resolution department whose main focus is on resolving outstanding insurance claims to ensure maximum payer reimbursement for clients.

The ideal candidate for this position is extremely organized, highly attentive to detail, professional, takes initiative, and values the importance of efficiencies. S/he should be comfortable with technology systems, and needs to be able to speak / read / write & understand American English.

Required Skills and Duties:

The Medical Billing Specialist should have skills for and experience in office practices and procedures in U.S. Healthcare. Proficiency in computer use and data entry is essential. Computer experience, including, but not limited to: word processing and spreadsheet applications, with minimum of 40wpm typing speed and 10-key by touch. S/he must also be able to work well with people, maintain confidentiality, and communicate effectively.

Furthermore, skills and knowledge required include:

Experience in CPT, ICD-10, and Medical Terminology.
Familiarity with EOB’s, data entry, and working with insurance companies.
Critical thinking skills – utilizes available resources, seeks answers prior to asking for assistance, analyzes situations, and is capable of making decisions.
Knowledge of Microsoft products, Google Platform and Medical Billing software required. *experience with EHRs are a plus.
Ability to prioritize multiple tasks, projects, and demands successfully.
Can work independently, research and resolve issues, not afraid to answer questions using tools provided.
Close attention to detail, high accuracy, and stellar organizational skills are a must.
Desire to be part of a performance driven team taking responsibility for obtaining goals as set by management.
Maintain extreme confidentiality at all times to include, but not limited to patient, client, and colleague information.
Must be extremely detail oriented
Excellent customer service skills
Strong written and verbal communication skills
Ability to work well within a team as well as individually
Responsible use of confidential information
Perform to company standards of compliance with policies and procedures
Experience researching and relaying knowledge effectively is a plus

Functions and Duties of the role may include some or all of:

Take appropriate follow-up action on underpaid, no response, and denied claims.
Review account registration, charge entry, coding, payments and contractual adjustments posted, and account/claim history following steps to swiftly and efficiently resolve.
Research and effectively communicate payer trends and issues.
Research and resolve payer rejects and denials with a goal to prevent in the future.
Document actions in an accurate and concise manner.
Communicate effectively and professionally with insurance representatives, internal team members, and providers.
Identify, research, and resolve credit balances.
Other duties as assigned.

Required Experience
Education – high school diploma or GED equivalent. College degree preferred.
Experience – two (2) years in revenue cycle – insurance resolution (claims follow up) highly preferred.