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Medical Billing Specialist

Company: Lags Spine and Sportcare Medical Centers Inc
Location: Hanford
Posted on: December 22, 2019

Job Description:

Description:
Looking for a well-rounded Medical Billing Specialist. Ideal candidate will have a minimum of 2 years, strong hands on application of ICD-10, CPT, and HCPCS coding systems and E&M Auditing and ChartAuditing, as well as Medical Office Management background. Candidate must have the ability to work toward creating and maintaining good relationships with physicians, supervisors, co-workers, insurance carriers and patients. Additionally, ideal candidate will foster working as a team; dealing with and resolving conflict in a timely, efficient and positive manner and is willing to mentor and train non-billing staff about insurance and billing workflows pertinent to their particular job functions (i.e. front office, collections, eligibility, benefits and authorizations teams, etc)..

Requirements:
Knowledge, Skills and Abilities:1) Knowledge and strong hands on application of ICD-10, CPT and HCPCS coding systems2) Knowledge and strong hands on application of chart review and documentation auditing3) Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensation and their billing guidelines and processes4) Knowledge of electronic medical record systems5) Knowledge of manual and electronic billing systems and procedures6) Knowledge of eligibility, benefits and authorizations processes7) Knowledge of general office procedures to create efficient and positive work environment8) Knowledge of all health care services offered by each clinic site9) Skill in communicating effectively to peers, supervisors and patients and to handle stressful situations appropriately10) Skill in operating personal computer utilizing word processing, spreadsheets, databases, email and other office equipment11) Maintains accurate and timely billing12) Audits insurance information for appropriateness in current billing system and is able to quickly identify underpayments or other trends that may negatively affect cash flows13) Ability to prioritize work and able to work with little or no supervision14) Ability to communicate both verbally and written effectively and efficiently15) Ability to maintain confidentiality of information, most importantly patient financial and medical information16) Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form17) Follows timely filing guidelines per payer to ensure maximum payment18) Ability to understand and respond appropriately, effectively, sensitively to special population groups as defined by race, ethnicity, language, age, sex, etc.19) Ability to hear and speak well enough to converse over telephone20) Ability to see well enough to use computer efficiently and read computer reports and correspondence21) Strong Excel, Word and Power Point skills22) Willingness to learn, understand and abide by company policies and proceduresProductivity:1) Ensures billing of services meet standards set by medical corporation2) Uses good judgment when auditing, preparing and billing charges to other entities for payment3) Completion of daily, weekly and added special projectsQuality Management:1) Constantly alert for ways to improve customer service, improve patient flow, increase productivity, and improve utilization of resources communicating ideas to supervisor2) Maintains infrequency of denials in the billing process3) Ensures that electronic and hard copy claims are accurate and completed on time.4) Verifies and ensures competency when utilizing EMR and Billing systems5) Uses mathematical accuracy and attention to detail6) Audits of invalid/rejected edits for accuracy in the electronic claims submission7) Ensures provider correction requests are responded back to billing timely8) Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patient complaints9) Attends and actively participates in staff meetings as requested10) Attends and actively participates in staff trainings, webinars and seminars as requestedReliability:1) Positively supports requests from administrative office and supervisor in implementing policy and new programs2) Dependable and punctualCustomer Service:1) Sets the example of exemplary patient and insurance customer service2) Responds to patient or insurance representative calls in a professional manner3) Reviews the terms of service performed, sliding fees, third party payments and payment collection with patient via telephone4) Ensures cleanliness of work environment during operational hours and is always prepared to provide friendly assistance to patients, insurance and staff membersLags Medical Centers are the primary musculoskeletal providers for California's Ventura County, Central Coast, Central Valley and Bay area. We use state-of-the-art diagnostics to help in creating individualized treatment plans to effectively manage and alleviate pain.We offer a comprehensive benefit package including medical, dental, vision, 401k, PTO and much more. PI116479012

Keywords: Lags Spine and Sportcare Medical Centers Inc, Hanford , Medical Billing Specialist, Accounting, Auditing , Hanford, California

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