Medical Billing Specialist

American Family Care Ladera Ranch; Dallas (TX); On-site; USD 45,000 - 75,000; Full time

Benefits offered by this job

Flexible scheduling

Paid vacation

Health insurance

Dental insurance

Retirement benefit

Great small business work environment

Job summary

Join a leading urgent care provider dedicated to delivering exceptional patient care! In this role, you will utilize your expertise in medical billing and coding to manage claims and ensure compliance with healthcare regulations. You'll work in a supportive small business environment that values flexibility and teamwork. This position offers the opportunity to make a significant impact on operational efficiency while navigating the complexities of insurance collections and appeals. If you are passionate about patient care and have a strong background in medical billing, this is the perfect opportunity for you to thrive in a rewarding and dynamic setting.

Qualifications

• 2+ years of experience in medical billing with a focus on denials and insurance follow-up.
• Strong skills in ICD-10 and CPT coding, with a preferred CPC certification.

Responsibilities

• Organize and prioritize incoming claims and denials for efficient processing.
• Evaluate claims to determine validity for appeals and ensure compliance with billing standards.

Skills

Medical practice billing

ICD-10 coding

CPT coding

MS Office applications

Insurance collections

Patient-first mindset

Education

CPC certification

Tools

Computerized billing systems

Job description

Benefits/Perks

Great small business work environment

Flexible scheduling

Paid vacation, health insurance, dental insurance, retirement benefit, and more!

Company Overview

American Family Care (AFC) is one of the largest primary and urgent care companies in the U.S. providing services seven days a week on a walk-in basis. Our state-of-the-art centers focus on the episodic treatment of acute illnesses and injuries, workers' compensation, and occupational medicine. Each location is equipped with an onsite lab and in-house x-ray capability.

AFC is the parent company of AFC Franchising, LLC (AFCF). This position works directly with a franchised business location. The specific job duties and benefits can vary between franchises.

Candidates Must Have:

1. At least 2 years of experience in medical practice billing with exposure to working with denials, appeals, insurance collections, and related follow-up
2. Working knowledge of Local and National Coverage Determinations and payor policies, and how to use them
3. Must have ICD-10 and CPT coding assessment skills; CPC certification is preferred
4. Strong proficiency in MS Office applications (Word, Excel, PowerPoint), and computerized billing systems is required
5. A patient-first, mission-oriented mindset

Duties:

1. Organize and prioritize all incoming claims and denials
2. Evaluate medical claims and coverage policy documentation to determine validity for an appeal
3. Responsible for ensuring and monitoring the effectuation of all decisions as a result of the follow-up of unpaid/denied claims with insurance carriers
4. Responsible for adhering to health care billing procedures, documentation, regulations, payment cycles, and standards
5. Work accounts to resolution
6. Collection from patients and insurances
7. Works collaboratively and effectively with all other departments and functions to maximize operational efficiency and service and ensure consistency in addressing appeals issues
8. Work independently to identify and resolve complex client problems
9. Work with leadership to develop appropriate policies and procedures
10. Maintain current knowledge of healthcare billing laws, rules and regulations, and developments
11. Comply with all applicable HIPAA policies and procedures and maintain confidentiality