Medical Billing Specialist

Medical Pathology Management, LLC; Houston (TX); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

In-office position

Job summary

Medical Pathology Management, LLC is seeking a Medical Billing Specialist to accurately process insurance claims and patient/client billing for pathology procedures. This in-office role requires handling denials, coordinating benefits, and posting payments with meticulous attention to detail.

The ideal candidate has 2 years of billing/coding experience, knowledge of CPT/ICD-10 and 10-key accuracy, and strong communication with payers to resolve issues and ensure timely payments.

Qualifications

• Two years in billing/coding within the last five years.
• Accurate 10-key ability.
• Knowledge of EOBs, CPT & ICD-10 codes, HCFA/CMS1500 forms.
• Experience researching denials and resolving for payment.
• Knowledge of government and commercial insurance billing, appeals, and prior authorization.

Responsibilities

• Follow the Revenue Cycle workflow.
• Ensure accurate and complete patient demographics are captured in the billing software.
• Verifying eligibility and coordination of benefits; making updates for clean claim submission.
• Scrub all new claims and resubmissions for accuracy in coding based on payer.
• 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 using 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.

Skills

Billing & coding experience

Denials research

Payer communications

Attention to detail

Education

High School Diploma or GED

Healthcare billing certification (preferred)

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