Medical Billing Specialist

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.