Medical Claims Specialist
3 days ago
TMDPH Inc. is a leading healthcare organization seeking an experienced Medical Biller to join our team.
Job SummaryWe are looking for a highly skilled and detail-oriented individual to play a critical role in ensuring accurate and timely billing processes for medical services provided to patients.
Key Responsibilities:- Review and verify accuracy of patient information, diagnoses, and medical procedures for proper coding and billing.
- Prepare and submit medical claims to insurance companies and other third-party payers accurately and within established timelines.
- Follow up on outstanding claims, denials, and discrepancies to ensure timely and complete reimbursement.
- Process and track payments received from insurance companies, patients, and other sources.
- Investigate and resolve billing discrepancies or errors, working collaboratively with internal and external stakeholders.
- Maintain up-to-date knowledge of medical billing regulations, coding guidelines, and insurance requirements.
- Communicate with patients, insurance companies, and other relevant parties to address billing inquiries, provide explanations of benefits, and ensure accurate billing information.
- Maintain patient confidentiality and adhere to ethical standards when handling sensitive financial and medical information.
- Assist with generating financial reports and analyzing billing data for insights into revenue cycles and trends.
- Collaborate with healthcare providers, administrative staff to ensure effective billing operations.
- Bachelor's Degree in any field.
- An associate's degree or certification in Medical Billing and Coding is an advantage but not required.
- Proficient understanding of medical billing procedures, insurance claims, and coding systems (CPT, ICD-10, HCPCS).
- Familiarity with billing software and electronic health record (EHR) systems.
- Strong attention to detail and analytical skills to review and process billing information accurately.
- Excellent written and verbal communication skills for effective interaction with patients and insurance representatives.
- Ability to work independently, manage priorities, and meet billing deadlines.
The estimated salary range for this position is $45,000 - $65,000 per year, depending on experience and qualifications.
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