Medical Billing Specialist

ADG Pathology; Houston (TX); On-site; USD 38,000 - 60,000; Full time

Job summary

MPA in Houston, TX seeks a Medical Billing Specialist to process insurance claims and patient invoicing for pathology procedures. You will post payments, handle denials, and coordinate with payers and patients to resolve issues, ensuring timely cash flow for the practice.

Requirements include a high school diploma or GED, 2 years billing/coding experience, and proficiency with CPT, ICD-10, EOBs, and relevant billing software. This is an in-office role.

Qualifications

• High School Diploma or GED required; relevant certificate preferred.
• Two years billing/coding experience within the last five years.
• Accurate 10-key ability.
• Knowledge of EOBs, CPT & ICD-10 codes, HCFA, CMS1500.
• Experience researching denials and pursuing payment.

Responsibilities

• Follow Revenue Cycle workflow.
• Capture accurate patient demographics in billing software; notify staff of discrepancies.
• Verify eligibility and coordination of benefits; ensure clean claim submissions.
• Scrub new claims and resubmissions for coding accuracy by payer, rendering provider, and billing group.
• Post payments and adjustments from payers.
• Handle assigned and unassigned denials promptly.
• Follow up on unpaid claims via payer portals or contact.
• Identify trends in denials and communicate with management.
• Resolve issues to assure payment.
• Interact with insurance companies, clients, and patients to support payment.

Skills

Billing

Accurate 10-key

Denials research

Customer service

Education

High School Diploma or GED

Tools

Billing software

Payer portals

Job description

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.

We deliver not only the broadest range of services but also the highest quality results, including access to advanced testing and molecular diagnostics. Our pathologists regularly collaborate internally and consult with experts at world class institutions to assist with challenging cases.

The Medical Billing Specialist Accurately process insurance claims, invoices patient and client billing for pathology procedures. Collect payments from multiple sources, post and document all transactions. Manage issues and problems effectively for the best outcome for the company, our clients and patients.

This is a fully 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