Medical Billing Specialist

Job Description

Required Education: High School Graduate or Equivalent
Preferred Education: CPC or CCS, certified coder either through AAPC or an equivalent organization

Experience: 1 years’ experience in the medical coding field. Must have good knowledge of medical terminology, anatomy, diagnosis and procedure codes.

• Must be well versed in CPT and ICD-10 coding. Orthopaedic and Spine specific billing and coding background preferred.
• Knowledge of insurance contracts, CMS and managed care guidelines, medical terminology and medical compliance.
• Must have in-depth knowledge of the appeals process and ability to successfully appeal unjust denials
• Send claims (paper and electronic)
• Follow up on submitted claims and outstanding A/R
• Keeping accounts current, posting payments for all claims
• Monitors uncharged encounters in EMR system and sends notices to Physician offices on missing charges.
• Apply analytical and critical thinking to determine any areas which fall below reimbursement expectations and provide timely recommendations— to resolve those matters.
• Comfortable with all aspects of EHR/EMR systems. Experience in credentialing, CAQH, and PQRS requirements
• Must be proficient in MS Word, Excel, and Power Point
• Stays informed and up to date on coding issues by attending seminars. Possesses a comprehensive understanding of carrier specific, State or Federal billing guidelines.
• Preferred Experience: ASC Credentialing and Contracting

Job Type: Full-time