Billing Specialist

Medical Pathology Associates; Greenwood Village (CO); On-site; USD 40,000 - 55,000; Full time

Job summary

Medical Pathology Associates (MPA) is seeking a dedicated billing specialist to manage insurance claims and client billing in their Greenwood Village location. The role involves ensuring accuracy in claim submissions and effective resolution of payment denials.

The ideal candidate will have a High School diploma and at least two years of relevant experience. This position requires strong attention to detail and expertise in navigating billing software and insurance processes.

Qualifications

• Two years of billing/coding experience within the last five years.
• Knowledge of CPT & ICD-10 codes.
• Experience in resolving payment denials.

Responsibilities

• Process insurance claims and manage billing.
• Ensure accurate patient demographics.
• Follow up on unpaid claims and identify denial trends.

Skills

10-key accuracy

Knowledge of EOBs

Problem-solving

Ability to research denials

Education

High School Diploma or GED

Certificate in healthcare billing

Tools

Billing software

Job description

Medical Pathology Associates ("MPA") prides itself on performing pathology services at the highest level of quality, reliability and service to clinicians and their patients. We process tissue in a state-of-the-art laboratory that is centrally located in Houston, Texas. Through rigorous quality assurance and an expertise in pathology, MPA strives to continually improve diagnostic precision and ensure that patients receive the best possible care.

Accurately process insurance claims, prompt pay and client billing for pathology procedures.

Collect and post payments received from multiple sources and document all transactions.

Manage issues and problems effectively for the best outcome for the company, our clients and patients.

Key Job Functions

• Follow the Revenue Cycle workflow
• Ensure accurate and complete patient demographics are captured in the billing software. Communicate updates to administrative staff when discrepancies occur.
• Verifying eligibility and coordination of benefits. Making updates as necessary for clean claim submission.
• Scrub all new claims and resubmissions for accuracy in coding based on payer, rendering provider and billing group.
• Post payments and adjustments received from payers
• Work assigned and unassigned denials in a timely manner.
• Follow up on all unpaid claims by contacting the payer or utilizing online provider portals.
• Identify trends in denials, payment and non-payment and communicate issues to management and team.
• Research, document and resolve issues to assure payment.
• Follow up on all paper and electronic correspondence from payers and patients.
• Interact with insurance companies, clients and patients to support the payment process.

Qualifications

• High School Diploma or GED required. Certificate in healthcare billing preferred
• Two years in billing/coding experience within the last five years
• Accurate 10-key ability
• Knowledge of EOBs, CPT & ICD-10 codes, HCFAs, CMS1500, HCPCS
• Experience in researching denials and how to resolve for payment
• Knowledge of government and commercial insurance billing, appeals, and prior authorization