Medical Billing Specialist Job Description
Medical billing specialist
provides customer service to patients by educating them on insurance policies, billing procedures and coding issues.
Medical Billing Specialist Duties & Responsibilities
To write an effective medical billing specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included medical billing specialist job description templates that you can modify and use.
Sample responsibilities for this position include:
Strong excel knowledge – including pivot tables
Performs analysis and is involved in the day to day operations of the billing process
Reviews and analysis each billing cycle to ensure accuracy
Perform reconciliations and balancing of invoice detail
Minimum of 3 years working in insurance billing or 2 year college degree inaccounting/finance
Perform billing and verification services in collaboration with physician offices
Perform billing error report and review
Troubleshoot and solve problems efficiently and effectively
Perform generation of Patient Occasion of Service profile
Review daily Defect and Denial reports
Medical Billing Specialist Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Medical Billing Specialist
List any licenses or certifications required by the position: CPC, CPT, EPIC, ICD
Education for Medical Billing Specialist
Typically a job would require a certain level of education.
Employers hiring for the medical billing specialist job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Associates, Business, Accounting, Medical Billing, Business/Administration, Education, Healthcare, Medical, Finance, Supervision
Skills for Medical Billing Specialist
Desired skills for medical billing specialist include:
Medical terminology
Insurance industry
Billing practices and clinic policies and procedures
Coding and clinic operating policies
Medicare
Medicaid
Insurance guidelines
Explanation of benefits
Excel
Word
Desired experience for medical billing specialist includes:
Contact insurance companies by phone, email, fax, and written correspondence to resolve issues preventing claims from being processed correctly
Communicate with coding staff to verify claims have been coded correctly and appeal claims that have been paid incorrectly
Follows Best Practices regarding initial follow-up at 21- 28 days for insurance claims and subsequent follow-up every 14-21 days
Attends required meetings and participates in committees
Provides business office and admissions back up as needed
Performs follow up activities timely on all accounts to ensure prompt payment
Medical Billing Specialist Examples
1
Medical Billing Specialist Job Description
Job Description Example
Our innovative and growing company is hiring for a medical billing specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for medical billing specialist
- Charges and Payment posting
- Sending claims to clearinghouse
- Follow up on patient and insurance claims
- Answer patient phone calls
- Maintain and release all-ship-verified claims for all third party claim
- Serve as back-up support in any administrative task needed for Occupational Health Clinic (OHC) operation
- Assist in coordinating outreach events and assist in preparation of materials
- Other duties may also be assigned by the OHC Operations Manager or EH&S Management
- Resolve errors and make claim edits assigned in work queue
- Follow work list prioritization of accounts as established by department policies and procedures for resolving accounts and/or submitting claim
Qualifications for medical billing specialist
- Knowledge of billing and payment policies of various third-party payers as they relate to ambulatory surgeries
- Preferred experience in collections and accounts receivables
- Complete A/R adjustments where permitted and appropriate
- Comply with and adhere to all regulatory compliance areas, policies and
- Constantly perform desk-based computer tasks, including use of a telephone
- Rarely stand, walk, reach or work above shoulders
2
Medical Billing Specialist Job Description
Job Description Example
Our growing company is looking for a medical billing specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for medical billing specialist
- Processes all insurance provider's correspondence, signature, and insurance forms
- Follows up with insurance companies and ensures claims are paid/processed
- Resubmits insurance claims that have received no response or are not on file
- Works with other staff to follow up on accounts until zero balance
- Assists in error resolution
- Answers telephone, screen calls, takes messages, and provides information
- Serves as a member of the Front End Team
- Assists patients in completing all necessary forms, to include payment arrangements made with patients
- Maintains compliance with HIPPA laws for patient confidentiality
- Collect unpaid or partially paid claims on behalf of clients
Qualifications for medical billing specialist
- Assist department management as necessary
- Medical Billing Certification a plus
- A working knowledge of insurances
- All accounts receivable functions including accurate and timely capture of all charges
- Payments and adjustments
- Insurance pre-certifications and pre-authorizations
3
Medical Billing Specialist Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of medical billing specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for medical billing specialist
- Assures that all phases of processing client information are in compliance with HIPAA, PHI regulatory and related policies and practices
- Manages the entry of client information into the ERP system
- Responsible for the timely follow-up and collection of payments due to the organization
- Assists in the processing of insurance claims
- Completes all necessary insurance forms
- Transmits daily all electronic claims to third party payors
- Develop proficiency in processing the minimum number of requisition forms per hour within the 90-day probationary period of employment
- Process claims and invoices
- Submit accurate invoices to payer for products and services provided
- Determine quantities and prices for items billed
Qualifications for medical billing specialist
- Negotiating and collecting past due accounts
- Referring accounts to collection agencies
- Responsible for preparing and sending moderately complex correspondence and reports
- Answers telephones, responds to patients' accounts receivable inquiries
- 2 years’ experience in a Medical/Healthcare Billing environment required
- 2 to 4 years of MEDICAL BILLING experience is a MUST
4
Medical Billing Specialist Job Description
Job Description Example
Our company is growing rapidly and is hiring for a medical billing specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for medical billing specialist
- Codes the surgical procedures preformed from the day before by the operative report or the surgeon’s note in the patient chart
- Ensures that the electronic and hard copy billing is complete and sent on a daily basis
- Performs all data entry required for entry of patient payments and insurance payments into computer system
- Insures that all corrected information on the patient registration form is corrected in the computer
- Checks that accounts for proper debit and credit adjustments
- Follow-up with each center to obtain and complete coding on a daily basis
- Monitor online claims submission and correct any rejections
- Identify problems with online claims submission promptly
- Performs statistical analysis and other clerical duties as requested by the Business Office Manager
- Assists in the End of Month process
Qualifications for medical billing specialist
- Must have 2+ years of healthcare billing collections and reimbursement management experience
- Able to manage accounts receivable activities and work with third party payers
- Proficient in Microsoft Office and able to learn other computer programs easily
- Must be able to actively engage within the team and be a team player
- Familiar with health-care collection guidelines and practices
- Knowledge of insurance payment processing
5
Medical Billing Specialist Job Description
Job Description Example
Our company is growing rapidly and is looking for a medical billing specialist. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for medical billing specialist
- Has knowledge of medical terminology likely to be encountered in medical claims
- Back up for Patient Account Representative/Collections
- Functions as a team member in the business office and assists clinical staff when necessary
- Prepare reports for management as requested
- Verifies successful import of claims from host system daily
- Timely submission of clean, accurate claims of all hospitals assigned either electronic or paper according to payer/hospital requirements and following specific state and federal guidelines per established procedures
- Works errors and halted claims daily
- Utilizes electronic software in all daily activities, documenting account daily following established procedures
- Promotes working toward paperless environment by identifying potential new electronic payors
- Ensures professional verbal and written communication with facilities, clients and co-workers following established guidelines
Qualifications for medical billing specialist
- Insurance claim filing, monitoring and follow-up, including appeals
- Ability to maintain speed and accuracy
- Ability to approach problems/decisions analytically with attention to detail
- Minimum 2 years of experience as a Medical Biller
- Ability to quickly learn medical billing software
- Proficiency in the operation of EMRs