Medical Billing Specialist: Claims & Denials Expert

Pafford Emergency Medical Services; Pagedangan; On-site; IDR 725,689,000 - 1,179,245,000; Full time

Job summary

Pafford Emergency Medical Services is looking for a Billing Specialist to manage referrals and pre/post-authorizations, verify eligibility, and submit ambulance service claims. This role requires attention to detail and knowledge of medical billing processes.

You will review claims for accuracy, follow up on unpaid or denied claims, and maintain HIPAA compliance while communicating with patients and payers. High school diploma or GED and revenue cycle experience are preferred.

Qualifications

• Proficient with a PC and standard office software.
• Knowledge of HIPAA and patient privacy requirements.
• Knowledge of HCPCS and ICD-10 coding.
• Familiarity with medical terminology and billing terminology.
• Understanding of insurance guidelines including HMOs, PPOs, Medicare and Medicaid.
• Strong customer service skills for interacting with patients and payers.

Responsibilities

• Obtain referrals and pre/post-authorizations for ambulance services.
• Check eligibility and benefits verification.
• Review claims for accuracy and completeness.
• Prepare, review, and transmit claims using billing software and payer websites.
• Follow up on unpaid claims within standard billing cycle timeframe.

Skills

HIPAA knowledge

HCPCS ICD-10 codes

Medical terminology

Revenue cycle knowledge

Customer service

Problem solving

Independent work

Communication

Office practices

Education

High School Diploma or GED

Tools

MS Word

Excel

Billing software

Clearinghouse

Payer websites

10-key

Job description

Pafford Emergency Medical Services is looking for a Billing Specialist to manage referrals and pre/post-authorizations, verify eligibility, and submit ambulance service claims. This role requires attention to detail and knowledge of medical billing processes.

You will review claims for accuracy, follow up on unpaid or denied claims, and maintain HIPAA compliance while communicating with patients and payers. High school diploma or GED and revenue cycle experience are preferred.