Medical Billing Claims Specialist

Mambo Seafood Restaurants; Lawrenceville (GA); On-site; USD 40,000 - 80,000; Full time

Job summary

An established industry player in pain management is seeking a dedicated Medical Billing Specialist to join their expanding team. This full-time position offers a competitive salary and benefits, including PTO and a 401k match. The ideal candidate will have at least three years of experience in medical billing, with a strong understanding of CPT and ICD-10 coding. You will play a vital role in ensuring accurate claims processing and collaborating with a dynamic team. If you thrive in a fast-paced environment and are looking to make a significant impact in the healthcare sector, this opportunity is perfect for you.

Benefits

Health Benefits

401k Match

Paid Time Off

Qualifications

• 3+ years of experience in medical billing or revenue cycle management.
• Strong knowledge of CPT and ICD-10 coding and claims submission.

Responsibilities

• Audit and ensure claim information is complete and accurate.
• Handle claims submission for various procedures and services.
• Collaborate with billing staff to meet month-end closing deadlines.

Skills

Medical Billing

Claims Processing

CPT Coding

ICD-10 Coding

Microsoft Office

Revenue Cycle Management

Third-party Payers Knowledge

Multitasking

Education

Bachelor's Degree

Tools

eClinicalWorks

Job description

Job Title: Medical Billing Specialist

Summit Spine and Joint Centers is a rapidly expanding Pain Management Group seeking an experienced Medical Billing Specialist to join our team. With twelve ambulatory surgery centers and twenty-three clinic locations across Georgia, Summit Spine aims to become the largest comprehensive spine and joint care provider in the state. We are looking for a motivated and dedicated Claims Processor to be part of our growing team of professionals.

Job Duties:

• Audit and ensure claim information is complete and accurate.
• Handle claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
• Ensure accurate and timely billing of HCFA 1500 claims.
• Document files with appropriate information (e.g., date stamped, logged, signed).
• Create logs for providers regarding pending medical encounters or errors.
• Collaborate with other billing staff and management to meet month-end closing deadlines.
• Manage rejections from clearinghouses, including printing and mailing secondaries.
• Address inquiries from insurance companies, patients, and providers.
• Understand CPT, ICD-10, HCPCS coding, and modifiers.
• Have knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, and Worker's Compensation.
• Work with ERAs and EOBs.
• Follow payer-specific/LCD guidelines.
• Understand health plan benefits, deductibles, copays, coinsurance, and verify eligibility.
• Proficient in spreadsheets and word processing applications.

Qualifications:

• Minimum of 3 years’ experience in medical billing or revenue cycle management in a healthcare setting.
• Experience with Medicare, Medicaid, commercial insurance, workers’ comp, and personal injury cases.
• Knowledge of claims submission for various procedures and services.
• Understanding of medical billing rules, coordination of benefits, modifiers, EOBs, and ANSI code denials.
• Excellent knowledge of CPT and ICD-10 coding, with familiarity in medical pre-certification protocols.
• Strong computer skills, especially with Microsoft Office.
• Ability to adapt to a growing, dynamic organization and navigate change.
• Self-motivated with multitasking and prioritization skills in a fast-paced team environment.
• Bachelor’s degree preferred.
• Experience with eClinicalWorks and Pain Management billing preferred.

The position is full-time with a competitive salary, PTO, health benefits, and a 401k match. The ideal candidate should be located in Georgia or near Austin, Texas, and able to be present at our administrative office or nearby where other billing team members are located.