Pathology Revenue Cycle Billing Specialist

Medpathassociates; Houston, Northern (TX, KY); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Medical Pathology Associates (MPA) in Houston, TX, is seeking an in-office Billing Specialist to accurately process insurance claims, post payments, and manage denials while coordinating with payers, clients, and patients.

The role requires 2+ years in billing/coding, knowledge of EOBs and CPT/ICD-10 coding, and strong 10-key accuracy. This is a full-time in-office position at our state-of-the-art laboratory in Houston.

Qualifications

• Two years in billing/coding experience within the last five years.
• Accurate 10-key ability.
• Knowledge of EOBs, CPT & ICD-10 codes, HCFA, CMS1500, HCPCS.
• Experience in 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.
• 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.

Skills

Billing/Coding experience

10-key accuracy

Denials research

EOBs, CPT/ICD-10, HCFA, CMS1500

Eligibility verification

Payer coordination

Education

High School Diploma or GED

Certificate in healthcare billing

Job description

Medical Pathology Associates (MPA) in Houston, TX, is seeking an in-office Billing Specialist to accurately process insurance claims, post payments, and manage denials while coordinating with payers, clients, and patients.

The role requires 2+ years in billing/coding, knowledge of EOBs and CPT/ICD-10 coding, and strong 10-key accuracy. This is a full-time in-office position at our state-of-the-art laboratory in Houston.