Claim Specialist / Medical Billing
About the position
- Responsibilities
- Work all assigned claims within specified time period.
- Review all assigned claims for correct assignment of ICD-10, CPT, HCPCS codes and modifiers.
- Follow protocol when billing selected services and performing specific claim functions.
- Maintain knowledge of insurance carrier specific billing requirements and apply to claims as needed.
- Maintain knowledge of Correct Coding Initiative (CCI) and familiarity with all major coding resources.
- Correct all identified errors on claims prior to submitting.
- Correct all returned claim denials assigned to you in a timely manner.
- Assist EDI, Insurance, and Customer Service Representatives in resolving claims issues.
- Communicate with site administration or providers as needed.
- Participate in professional development activities and maintain professional affiliations.
- Follow HIPAA guidelines for patient confidentiality and maintain security of Protected Health Information (PHI) and business information.
- Requirements
- Minimum 1-year medical billing and claims processing experience.
- High School diploma or GED.
- Strong attention to detail and organizational skills.
- Strong computer skills and understanding of insurances and healthcare billing.
- Knowledge of anatomy, physiology, and medical terminology necessary to correctly review claims for accuracy.
- Nice-to-haves
- Knowledge of eClinical Works preferred.
- Benefits
- Paid parental leave
- Paid maternity/paternity leave after 1 year employed and 1,250 hours worked.
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