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Senior Medical Billing Specialist
1 week ago
We are seeking a highly skilled Medical Billing Specialist to join our team at Pointwest Innovations Corp. As a key member of our revenue cycle management team, you will play a crucial role in preparing and submitting billing data and medical claims to insurance companies, Medicare, Medicaid, and third-party payers.
The ideal candidate will have excellent analytical and problem-solving skills for claim resolution, as well as strong leadership and mentoring abilities to train and support billing staff.
- Prepare and submit billing data and medical claims to insurance companies, Medicare, Medicaid, and third-party payers.
- Verify and ensure the accuracy of patient information, procedure codes and diagnosis codes in accordance with payer policies and compliance guidelines.
- Analyze and resolve complex billing issues, including high-valued claims, appeals, and insurance disputes.
- Resolve claim discrepancies, correct coding errors, and resubmit denied or rejected claims in a timely manner.
Your responsibilities will include:
- Managing the entire ER billing cycle, ensuring accuracy and compliance with industry regulations.
- Preparing and submitting billing data and medical claims to insurance companies, Medicare, Medicaid, and third-party payers.
- Verifying and ensuring the accuracy of patient information, procedure codes and diagnosis codes in accordance with payer policies and compliance guidelines.
- Analyzing and resolving complex billing issues, including high-valued claims, appeals, and insurance disputes.
To be successful in this role, you will need:
- A university/college degree.
- Excellent written and spoken communication skills.
- Strong analytical and problem-solving skills for claim resolution.
- Leadership and mentoring abilities to train and support billing staff.
- Detail-oriented with a strong focus on accuracy and compliance.
- Ability to work in a fast-paced ER environment with high patient volumes.
- At least 1 to 2 years experience in Medical Billing, preferably in an emergency room or urgent care setting.
- Experience in popular EMRs and medical coding/billing platforms is an asset.
- Strong understanding of CPT, ICD-10, HCPCS coding, and insurance guidelines.
- Certified Professional Biller (CPB) or Certified Professional Coder (CPC) is a plus.
