BILLING SPECIALIST

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    "description": "<p>The Medical Billing&nbsp;Specialist&nbsp;is responsible for&nbsp;reviewing, preparing, and&nbsp;submitting&nbsp;accurate&nbsp;medical claims to insurance carriers&nbsp;in a timely manner. This role ensures that all charges are supported by&nbsp;appropriate documentation, coding, and payer requirements prior to claim submission. The Medical Biller works closely with coding, prior authorization, and clinical teams to resolve claim discrepancies, correct errors, and ensure clean claims are&nbsp;submitted&nbsp;on the first pass whenever possible. The position plays a critical role in&nbsp;maintaining&nbsp;billing accuracy, minimizing denials, and supporting efficient revenue cycle operations.&nbsp;</p>\r\n\r\n<p>Essential Duties and Responsibilities:&nbsp;</p>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Review patient encounters and charges to ensure accuracy and completeness prior to claim submission.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Submit professional claims electronically and through payer portals&nbsp;in accordance with&nbsp;payer requirements and internal billing timelines.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Verify that CPT, HCPCS, modifiers, and ICD-10 codes are present and supported by provider documentation prior to billing.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Review and correct claim edits&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Work closely with coding and clinical teams to clarify&nbsp;documentation&nbsp;discrepancies&nbsp;impacting&nbsp;claim submission.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Identify&nbsp;trends in&nbsp;documentation errors and claim edits&nbsp;and report findings to management.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ensure claims are&nbsp;submitted&nbsp;within&nbsp;timely&nbsp;filing requirements for all insurance carriers.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Maintain patient confidentiality and&nbsp;comply with&nbsp;all HIPAA policies and organizational guidelines.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Assist&nbsp;with special projects and workflow improvements as assigned.&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<p>Required Skills and Abilities:&nbsp;</p>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ability to organize workload and manage time effectively&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ability to&nbsp;establish&nbsp;and maintain effective working relationships with providers, management, employees, and the public&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Strong computer and data entry skills&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ability to review claims for accuracy prior to submission&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ability to interpret payer billing guidelines and requirements&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ability to handle a high volume of work with speed and accuracy&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Ability to&nbsp;identify&nbsp;and resolve claim errors prior to submission&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Able to multi-task and work quickly with constantly changing circumstances and priorities&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Strong attention to detail&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul>\r\n\t<li>\r\n\t<p>Problem solving and critical thinking skills&nbsp;</p>\r\n\t</li>\r\n</ul>\r\n",
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