- The billing specialist will be part of the billing cycle to report to the billing manager.
- Task Pre-Billing:
- Is responsible for reading, interpreting, and analyzing medical notes and records to accurately understand a patient’s disease history and treatment plan.
- This role involves reviewing clinical documentation to ensure it accurately reflects the patient’s condition and the course of treatment.
- The specialist will work closely with healthcare providers to identify gaps or inaccuracies in documentation and ensure a comprehensive record of each patient’s medical history, diagnoses, and treatment plans.
- Will keep an eye on the insurance policies for any changes that might happen to ensure that the process will pass from the insurance's side.
- Great communication ability for internal and patient communication.
- Task Post-Billing:
- 1. Data Entry.
- 2. Eligibility.
- 3. Pre-authorization management.
- 4. Follow Up on Outstanding Claims: Regularly check on unpaid claims to ensure they are processed within the expected timeframe.
- 5. Investigate Claim Denials or Rejections: If a claim is denied or rejected, determine the reason, correct any issues, and resubmit the claim.
- 6. Appeals: If needed, file an appeal with the insurance company if the claim was denied unjustly or inaccurately.
3 to 5 years of experience in the medical billing field.Fluency in spoken and written English is a MUST.Knowledge of US Medical Insurance billing processesAbility to work the US time schedule (EST)Excellent computer skillsFlexibility and TeamworkExcellent Communication SkillsAbility to work independently and remotely