Billing Specialist

Medical Pathology Associates; Houston (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

Medical Pathology Associates in Houston, TX is seeking a Billing Specialist to manage the clinic's revenue cycle. In-office, full-time position focused on accurate claims processing and timely payments.

You will verify patient demographics, determine eligibility, scrub claims for proper coding, post payments and adjustments, and follow up on denials. Strong attention to detail and familiarity with CPT/ICD-10 codes are essential.

Qualifications

• Two years billing/coding experience in the last five years.
• High School Diploma or GED; healthcare billing certificate preferred.
• Accurate 10-key ability with attention to detail.
• Familiarity with government and commercial insurance billing, CPT/ICD-10, HCPCS, CMS-1500.

Responsibilities

• Follow the Revenue Cycle workflow.
• Verify patient demographics in billing software; communicate updates when discrepancies occur.
• Verify eligibility and coordination of benefits; update 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 denials in a timely manner and follow up on unpaid claims.
• Identify trends in denials and payment patterns; report to management.
• Research, document and resolve issues to assure payment.
• Communicate with payers, clients and patients to support the payment process.

Skills

Billing & coding

Denials resolution

CPT/ICD-10 knowledge

10-key typing

EOBs knowledge

Education

High School Diploma or GED

Healthcare billing certificate preferred

Job description

Billing Specialist

Medical Pathology Associates Houston, Texas, United States

About this position

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.

NOTE: THIS IS A FULL TIME, IN OFFICE POSITION!

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

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