Medical Billing and Coding Specialist – Remote | WFH

Job Description

Responsibilities
As a Medical Billing Specialist, you’ll collaborate closely with our Operations team to address various issues related to unbilled claims, authorizations, Physician Certification Statements (PCSs), Patient Care Reports (PCRs), insurance, and demographic capture concerns. Your key responsibilities will include…
Partnering with Operations to resolve issues concerning unbilled claims, authorizations, PCSs, PCRs, and insurance-related matters.
Escalating concerns regarding questionable paperwork to the appropriate management for further action.
Contacting payers via phone or web to verify claim status and diligently following up on unpaid claims.
Processing appeals for aged insurance claims and denials to ensure a smooth resolution.
Demonstrating an aptitude for analyzing, identifying, and resolving issues that could potentially cause delays in payer payments.
Identifying and addressing claim edits by comprehending billing guidelines and meeting payer requirements.
Reconciling commercial and government accounts, ensuring accuracy in CPT and diagnostic codes.
Interpreting terms for Managed Care, Commercial, Medicare, Medicaid, Workers’ Compensation, and No Fault, where applicable.
Reviewing Explanation of Benefits (EOBs) to ensure accuracy in payment, deductibles, adjustments, and denials.
Determining claim statuses with insurance companies to ensure compliance with contractual agreements or the necessity for adjustments.
Reconciling account balances and verifying the accurate application of payments.
Proactively managing aged accounts, promptly resolving and resubmitting denied unpaid claims efficiently.
Following up on appeals and corrected submitted claims to ensure timely resolution.
Reviewing and rectifying billing errors, leveraging strong knowledge of CPT and ICD-10 coding.
Auditing and rectifying customer service account inquiries to enhance service quality.
Handling inbound/outbound customer service calls and providing exceptional service to patients, insurances, and facilities.
Reviewing and rectifying all rejections in the clearinghouse system.
Performing any additional duties as assigned.
Qualifications
To succeed in this role, you should possess:
2-3 Years Of Essential Medical Billing Experience.
Preferred experience in ambulance billing.
Extensive knowledge and experience with Medicare and Medicaid, particularly in understanding medical necessity for ambulance transportation.
Proficiency in CPT and ICD-10 coding.
Preferred Certification Or Diploma In Ambulance/Medical Billing.
Preference for Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) certification.
Excellent organizational skills and the ability to multitask effectively in a fast-paced environment.
Analytical mindset, capable of collecting, researching data, and utilizing intuition and experience to complement data analysis.
Employment Type: Full-Time
Salary: $ 20.00 25.00 Per Hour