Medical Billing Expert

We are seeking a detail-oriented and experienced Medical Billing Expert to join our team. The ideal candidate will possess extensive knowledge of medical billing procedures, coding systems, and regulations. They will be responsible for accurately processing medical claims, ensuring compliance with insurance guidelines, and maximizing reimbursement for services rendered.

Key Responsibilities:

1. Reviewing patient medical records and encounter forms to accurately assign appropriate medical codes for billing purposes.
2. Submitting electronic or paper claims to insurance companies, government agencies, or other third-party payers.
3. Following up on unpaid or rejected claims, identifying and resolving billing discrepancies or errors.
4. Communicating with insurance companies, patients, and healthcare providers to address billing inquiries or disputes.
5. Verifying insurance eligibility and coverage, obtaining pre-authorizations when necessary.
6. Maintaining up-to-date knowledge of medical billing regulations, coding guidelines, and reimbursement policies.
7. Collaborating with healthcare providers and administrative staff to streamline billing processes and improve revenue cycle efficiency.
8. Generating reports and analyzing billing data to identify trends, track key performance indicators, and make recommendations for improvement.
9. Assisting with training and mentoring junior billing staff as needed.

Qualifications:

• Bachelor’s degree in healthcare administration, finance, or related field (preferred).
• Certification in medical billing and coding (e.g., CPC, CCS-P) strongly preferred.
• Minimum of 1 years of experience in medical billing, preferably in a healthcare setting.
• Proficiency with medical billing software and electronic health records (EHR) systems.
• Thorough understanding of medical terminology, anatomy, and physiology.
• Excellent communication skills, both written and verbal.
• Strong analytical and problem-solving abilities.
• Ability to work independently and as part of a team in a fast-paced environment.
• Attention to detail and accuracy are paramount.