Medical Billing Specialist

United Surgical Partners International; United States; Remote; USD 48,000 - 72,000; Full time

Job summary

United Surgical Partners International is seeking a Billing Specialist to manage daily charge entry for assigned surgical centers. You will review charts, verify demographics, and code charges to optimize reimbursement.

You will extract data from records, capture implants and high-cost items, and ensure accurate submission of claims. Experience with ASC billing and payer contracts is required, with strong MS Office skills and familiarity with billing systems.

Qualifications

• 2+ years ASC revenue cycle or orthopedic charge entry experience.
• Ability to read and interpret insurance explanations of benefits and managed care contracts.
• Must communicate effectively, both verbally and in writing, with internal and external clients.
• Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
• Knowledge or experience working with a variety of health care insurance payers is preferred.
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
• Advantx, Vision, HST, Waystar experience preferred.
• High School Diploma or equivalent.

Responsibilities

• Pull preoperative notes from the designated transcription company.
• Extract information from medical records and invoices to ensure completeness and accuracy of charge entry.
• Capture implants, high-cost supplies, high-cost drugs, post op pain blocks and observations times prior to charge submission.
• Review accuracy of invoice details, including pricing, discounts, state sales tax, etc.
• Execute the recurring billing workflow and generate and transmit claims daily.
• Ensure timely follow-up and resolution of billing inquiries from internal and external clients.
• Reconcile revenue and billing during period-end close.
• Complete accurate charge entry for all assigned cases and upload to the electronic claims clearinghouse daily.
• Resolve claim rejections daily to ensure clean claims are transmitted.
• Maintain current knowledge of health care billing laws, rules and regulations.

Skills

ASC revenue cycle

EOB interpretation

Communication skills

Multi-tasking

Payer knowledge

MS Office

Advantx/Vision/HST/Waystar

High School Diploma

Education

High School Diploma or equivalent

Job description

Position Overview

Reporting to the Billing Manager, Billing Specialists are responsible for the daily entry of charges for their assigned surgical centers. This will include but is not limited to the following: perform complete chart reviews, verify patient demographics, assign modifiers, diagnosis codes, and revenue codes in accordance with coding and reimbursement guidelines resulting in claim reimbursement.

Responsibilities

• Pull any preoperative notes from the designated transcription company.
• Extract information from medical records, operative notes, invoices, progress notes and discharge paperwork to ensure completeness and accuracy of charge entry.
• Capture implants, high-cost supplies, high-cost drugs, post op pain blocks and observations times prior to charge submission
• Review accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc.
• Execute the recurring billing workflow and generate and transmit claims daily.
• Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, POPM form, invoices, or implant pricing etc).
• Reconcile revenue and billing during the period-end close process.
• Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily.
• Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.
• Maintain current knowledge of health care billing laws, rules and regulations and developments.

Required Skills

• 2+ years of ASC revenue cycle or orthopedic charge entry or collections experience.
• Ability to read and interpret insurance explanations of benefits and managed care contracts.
• Must communicate effectively, both verbally and in writing, with internal and external clients.
• Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines
• Knowledge or experience working with a variety of health care insurance payers is preferred
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook
• Advantx, Vision, HST, Waystar experience preferred.
• High School Diploma or equivalent.