Health Information Specialist

VieMed Healthcare; Lafayette (LA); On-site; USD 48,000 - 64,000; Full time

Job summary

VieMed Healthcare in Lafayette, LA, is seeking a detail-oriented Medical Records and Billing Specialist to review insurance policies, explanations of benefits, and medical documentation for accuracy and compliance. You will manage medical records for home medical equipment, coordinate with patients, physicians, and internal teams, and perform internal audits and maintain audit logs.

Requires 2+ years in DME or medical billing, knowledge of CPT/ICD-10, HIPAA, and strong Microsoft Office skills;

Qualifications

• High School Diploma or equivalent.
• Knowledge of Explanation of Benefits from insurance companies.
• Working knowledge of government, regulatory billing and compliance for Medicare & Medicaid.
• Working knowledge of CPT/ICD-10 codes, HCFA 1500, UB04, HIPAA, and billing regulations.
• Knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Utilizes initiative with productive accuracy.

Responsibilities

• Review and understand Insurance policies and standard Explanation of Benefits.
• Review and understand medical documentation effectively.
• Review and resolve requests for medical records related to claims processing, audits, and authorized external entities.
• Monitor and maintain audit logs.
• Perform internal audits for quality assurance.
• Manage medical records for patients for home medical equipment.
• Maintain communication with patients/family, physicians’ offices, and internal teams.
• Handle clerical tasks such as answering calls, faxing, and emails.
• Report concerns to Revenue Cycle Manager and Supervisor.
• Other duties and projects as assigned.

Skills

Organizational skills

Microsoft Office

Attention to detail

Communication skills

Education

High School Diploma or equivalent

Tools

Outlook

Word

Excel

Microsoft Office

Job description

Duties:

• Review and understand Insurance policies and standard Explanation of Benefits.
• Review and understand medical documentation effectively.
• Review and resolve request for medical records, related to
  • Claims processing
  • Internal and external audits
  • Authorized external entities
• Monitors & maintains audit logs.
• Performs internal audits for quality assurance.
• Responsible for managing medical records of patients for insurance, private individuals and/or Government entities for home medical equipment.
• Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
• Performs other clerical tasks as needed, such as
  • Answering patient/Insurance calls
  • Faxing and Emails
• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor
• Other responsibilities and projects as assigned.

Duties:

• Review and understand Insurance policies and standard Explanation of Benefits.
• Review and understand medical documentation effectively.
• Review and resolve request for medical records, related to
  • Claims processing
  • Internal and external audits
  • Authorized external entities
• Monitors & maintains audit logs.
• Performs internal audits for quality assurance.
• Responsible for managing medical records of patients for insurance, private individuals and/or Government entities for home medical equipment.
• Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
• Performs other clerical tasks as needed, such as
  • Answering patient/Insurance calls
  • Faxing and Emails
• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor
• Other responsibilities and projects as assigned.

Requirements:

• High School Diploma or equivalent
• Knowledge of Explanation of Benefits from insurance companies
• Working knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid
• Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Experience:

• Minimum of 2 Years in DME experience required
• 3-5 Years in DME or medical billing experience preferred

Skills:

• Superior organizational skills.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Attention to detail and accuracy.
• Effective/professional communication skills (written and oral)