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Medical Billing Specialist

premier medical resourcesHouston, TXSenior L5
Medical Records SpecialistsBilling and Posting ClerksHealth Information Technologists and Medical Registrars
All Other Miscellaneous Ambulatory Health Care ServicesOffices of PhysiciansAll Other Outpatient Care Centers
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Medical Billing Specialist Revenue Cycle Management is looking for a full-time Medical Billing Specialist to join our team! Hybrid opportunity after 90 days of in-person training (2 days from home, 3 days in office).The Medical Billing Specialist is responsible for analyzing patient's records and coding the patient's records based on ICD-10 and CPT codes. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections.
Essential Functions:
  • Reviews patient accounts and supporting documentation to ensure all billable services and charges are captured accurately
  • Validates diagnosis and procedure codes on accounts for billing accuracy and payer requirements; escalates discrepancies for correction
  • Communicates with clinical, coding, and front-end teams to obtain or clarify missing or incomplete information
  • Prepares and submits accurate electronic and paper claims to commercial insurance carriers and government payers
  • Investigates and resolves claim denials and rejections, including appropriate corrections and resubmissions
  • Maintains accurate and up-to-date patient account information within the electronic medical record (EMR) and billing systems
  • Identifies trends or recurring issues impacting reimbursement and communicates findings to leadership
  • Ensures compliance with payer guidelines, company policies, and applicable regulations
  • Perform other related tasks as needed
  • Knowledge, Skills, and Abilities:
  • Knowledge of medical billing processes, including insurance verification, prior authorization, patient responsibility, and workers' compensation
  • Knowledge of explanation of benefits (EOBs), remittance advice, and coordination of benefits (COB) processing
  • Working knowledge of medical terminology and ICD-10, CPT, and HCPCS coding systems as they relate to billing accuracy
  • Knowledge of payer guidelines, including government and commercial insurance requirements, claims submission, and denial management
  • Proficient in electronic billing systems and claim forms, including HCFA Form CMS-1500 Experience with electronic medical records (EMR) and practice management systems
  • Strong analytical and problem-solving skills with the ability to identify and resolve billing discrepancies
  • High attention to detail and accuracy in reviewing and processing claims
  • Strong organizational and time management skills with the ability to prioritize tasks effectively
  • Ability to work independently with minimal supervision and adapt to changing priorities
  • Effective written and verbal communication skills, including the ability to communicate professionally with internal teams and external parties
  • Proficient in Microsoft Office applications, including Word, Excel, and PowerPoint
Education and Experience: High School Diploma or GEDThree (3) years of experience with medical billing, accounts receivable, or revenue cycle operations Medical billing certification in lieu of experience
Benefits:
  • 3 Medical Plans2 Dental Plans2 Vision Plans
  • Employee Assistant Program
  • Short- and Long-Term Disability Insurance
  • Accidental Death & Dismemberment Plan 401(k) with a 2-year vestingPTO + Holidays

Matching similar jobs

Level

Senior L5

Location

Houston, TX

Occupation

Medical Records Specialists

Industry

All Other Miscellaneous Ambulatory Health Care Services

Posted

2 days ago

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