Medical Billing Specialist

MedPath Management, LLC; Houston (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

MedPath Management, LLC in Houston, TX is seeking a Medical Billing Specialist to accurately process insurance claims, invoices, and patient billing for pathology procedures.

You will verify eligibility, scrub claims, post payments, follow up on denials, and interact with payers, clients, and patients in a fully in-office role.

Qualifications

• High School Diploma or GED required; certificate in healthcare billing preferred.
• Two years billing/coding experience within the last five years.
• Accurate 10-key ability; knowledge of EOBs, CPT & ICD-10 codes, HCPCS.
• Experience researching denials and how to resolve for payment.
• Knowledge of government and commercial insurance billing, appeals, and prior authorization.

Responsibilities

• Follow the Revenue Cycle workflow and ensure accurate patient demographics in billing software.
• Verify eligibility and coordination of benefits; update records when discrepancies occur.
• Scrub all new claims and resubmissions for accuracy in coding based on payer and billing group.
• Post payments and adjustments from payers; follow up on unpaid claims.
• Work assigned and unassigned denials in a timely manner; research and resolve issues for payment.
• Interact with insurance companies, clients and patients to support the payment process.

Skills

Billing experience

Coding knowledge

10-key accuracy

EOBs knowledge

CPT ICD-10 HCPCS

Denials research

Payer communication

Eligibility verification

Prior authorization

Education

High School Diploma or GED

Healthcare billing certificate

Tools

Billing software

Job description

Medical Billing Specialist

MedPath Management, LLC Houston, Texas, United States

About this position

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