Senior Medical Billing Specialist

The Senior Medical Billing Specialist will be responsible to ensure the accurate and timely processing of medical bills and claims. This role involves a combination of administrative, financial, and communication tasks to facilitate the smooth flow of revenue in a healthcare setting.

Responsibilities

• Verify and check patients’ insurance eligibility.
• Ensure all necessary information is collected for accurate billing.
• Prepare and submit billing data and medical claims to insurance companies.
• Maintain billing software by updating rate changes, cash spreadsheets, and current collection reports.
• Ensure the patient’s medical information is accurate and up to date.
• Examine patient bills for accuracy, requesting any missing information.
• Prepare bills and invoices for medical procedures and services.
• Document amounts due, creating a clear record of financial transactions.
• Collect and review referrals and pre authorizations.
• Ensure that proper documentation is in place before submitting claims.
• Monitor and record late payments.
• Follow up on missed payments, resolving financial discrepancies.
• Investigate and appeal denied claims, ensuring maximum reimbursement.
• Work with insurance companies to resolve claim disputes.
• Assist patients in developing payment plans.
• Provide information on financial assistance programs.

Qualifications

• In depth understanding of medical billing procedures, codes, and regulatory requirements.
• Proficiency in utilizing billing software and electronic health records (EHR) systems.
• Attention to detail and accuracy in claims processing and record keeping to prevent errors and discrepancies.
• Clear and coherent in both written and verbal communications skills for effective collaboration with internal teams, external stakeholders, and insurance entities.
• Strong problem solving skills, particularly in investigating and resolving denied claims and financial discrepancies.
• Ability to negotiate with insurance companies to maximize reimbursement and resolve claim disputes.
• Strong organizational skills to manage multiple tasks, deadlines, and the meticulous record keeping required in medical billing.
• Ability to adapt to changes in billing procedures, software, and industry regulations.

Screening Criteria

• MUST HAVE STABLE EMPLOYMENT HISTORY.
• Bachelor’s degree in business, healthcare administration, accounting, or a related field.
• Minimum of two (2) years of experience as a medical biller or a similar role.