BILLING SPECIALIST

Service Core inc.; Youngstown (OH); On-site; USD 38,000 - 52,000; Full time

Job summary

Service Core inc is seeking a Billing Specialist in Youngstown, OH to ensure accurate and timely submission of medical claims to insurance companies and government agencies. The role involves payment posting, statements, collections, denials handling, and prior authorizations, working closely with the Chief Fiscal Officer.

Candidates should have a high school diploma and at least two years of medical billing experience, knowledge of CPT codes, insurance guidelines, and proficiency with Microsoft

Qualifications

• Two years' experience in medical billing.
• Knowledge of insurance guidelines (HMO/PPO, Medicare, Medicaid).
• Positive customer service abilities.
• Proficiency with Excel and Electronic Billing systems.

Responsibilities

• Prepare and submit medical claims to insurance and government programs.
• Verify insurance and patient payments posting.
• Apply CPT codes and conduct coding reviews for accuracy.
• Identify and resolve billing discrepancies.
• Prepare and submit billing data and claims.
• Insurance verification and research.
• Generate statements and post payments.
• Monitor EDI portal to research and resubmit rejected claims.
• Follow up on missed payments and resolve discrepancies.
• Review denied claims and resubmit.
• Investigate underpayments and denials not coding-related.
• Report rejection trends and address root causes.
• Comply with policies and regulatory standards for billing and patient privacy.

Skills

Medical billing

Insurance verification

Customer service

CPT coding

Data entry

Communication skills

Microsoft Excel

Education

High School Diploma

Tools

Electronic Billing systems

Microsoft Office Suite

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

BILLING SPECIALIST

OVERVIEW:

Ensure accurate and timely submission of medical claims to insurance companies and government agencies, payment posting, statements and collection management, insurance denials and prior authorizations. Must be able to work independently and efficiently. The Medical Biller will work closely with the Chief Fiscal Officer to manage the billing submittal and corrections.

RESPONSIBILITIES:

• Prepare and submit medical claims to insurance companies and government agencies.
• Verify insurance payment and patient payment posting.
• Knowledge of CPT codes
• Conduct medical coding reviews to ensure compliance and accuracy.
• Identify and resolve billing discrepancies.
• Preparing and submitting billing data and medical claims to insurance companies.
• Insurance verification
• Generating statements and posting payments
• Monitor the electronic data interchange portal daily to research, resolve, and resubmit the previous day's claims that were rejected.
• Following up on missed payments and resolving financial discrepancies.
• Review any claims denied by the insurance carrier and work to resolve and resubmit
• Research and resolve all underpayments and denials that are not coding-related.
• Report rejection trends and work to resolve the root cause of rejections.
• Comply with company policies and compliance requirements, and perform work in compliance with regulatory standards about billing, patient privacy, protection of electronic health information, etc.

QUALIFICATIONS:

• High school diploma or equivalent, plus two years' experience in medical billing work.
• Must possess Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
• Must possess positive customer service abilities.
• Must have full knowledge of the work processor, Microsoft Office, Excel and experience with the Electronic Billing systems.

PHYSICAL REQUIREMENTS:

• Prolonged periods of standing and walking.
• Frequently required to sit, reach with hands and arms, and stoop, kneel, crouch, or crawl.
• Must be able to lift and/or move 25 pounds.