Quality Assurance Medical Billing Specialist
Description

Salary Range: $17.50-22.50 per hour plus benefits

Full/Part-time: Full Time


Purpose of Position:

· Collect and enter claim information.

· Post insurance payments and manage accounts.

· Submit claims and follow up with insurance carriers on unpaid or rejected claims.

· Answer inquires on account status and charges.

· Ensure billing practices are ethical and compliant with government regulations and guidelines

Essential Functions:

· Review daily member logs, transportation logs, and Center case management sessions data entry is accurate, complete and timely

· Monitors batch claim submission

· Posts insurance and patient payments using medical claim billing software.

· May perform “soft” collections for past due accounts. This may include contacting and notifying health plans via phone or mail.

· For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer.

· Follows HIPAA guidelines in handling patient information.

· May periodically create insurance or patient aging reports using the medical practice billing software. These reports are used to identify unpaid insurance claims or patient accounts.

· Understands managed care authorizations and limits to coverage such as the number of visits. 

· May have to verify patient benefits eligibility and coverage.

· Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references.

· Collects and enters claim information

· Submit claims and following up with insurance carriers on unpaid or rejected claims.

· Other duties as assigned

Requirements

Education:

GED or High School Diploma

Experience:

1+ yr billing experience 

1 + yr experience Commercial Electronic Healthcare Records (EHR) software  

  

Knowledge, Skills & Abilities:

  • Knowledgeable on insurance and reimbursement process.
  • Good math and data entry (typing) skills.
  • Exercises good judgement and discretion.
  • Familiarity with HIPAA privacy requirements for patient information. Maintains and      protects confidential information.
  • Proficient in use of computers and common office equipment.
  • Good verbal and written communication skills.
  • Basic understanding of medical ICD 9-10 codes and CPT medical billing codes.
  • Good telephone and patient relation skills.
  • Detail oriented and ability to prioritize work.
  • Work with minimal direction and oversight.

Other requirements:

  • At least 21 years of age
  • Criminal Background Verification       
  • Pre-Hire and Random Drug/Alcohol Screening
  • Covid-19 vaccination/Booster