Prior Authorization/ Billing specialist

Job Summary
We are seeking a detail-oriented and experienced Billing Clerk to join our healthcare team. The ideal candidate will be responsible for managing medical billing processes, ensuring accurate coding, and maintaining comprehensive medical records. This role requires strong knowledge of medical billing procedures, coding systems, and electronic health record (EHR) systems to facilitate efficient claim submissions and collections. The Billing Clerk plays a vital role in supporting the financial health of the practice while ensuring compliance with industry standards.

Duties

• Prepare and submit accurate insurance claims using DRG, CPT coding, ICD-9, ICD-10, and ICD coding standards.
• Review and verify medical records for completeness and accuracy prior to billing.
• Manage accounts receivable by following up on unpaid claims and patient balances through medical collection processes.
• Utilize EMR and EHR systems to document billing information and update patient records efficiently.
• Collaborate with medical staff to ensure proper documentation of services rendered with appropriate medical terminology.
• Reconcile billing discrepancies and resolve claim denials promptly to ensure timely reimbursement.
• Maintain organized records of all billing transactions, claims, and correspondence for audit purposes.
• Stay updated on changes in medical coding regulations and insurance policies to ensure compliance.

Qualifications

• Proven experience in medical billing, medical office administration, or related roles.
• Strong knowledge of DRG, CPT coding, ICD-9, ICD-10, ICD coding, and medical terminology.
• Familiarity with EMR and EHR systems used in healthcare settings.
• Experience with medical records management and medical collection procedures.
• Ability to interpret complex medical documentation accurately for coding purposes.
• Excellent organizational skills with attention to detail to ensure error-free billing processes.
• Effective communication skills for collaborating with healthcare providers, insurance companies, and patients.
• Prior experience working with medical coding standards and insurance claim submissions is highly desirable. This position offers an opportunity to contribute significantly to the efficiency of our healthcare operations while working in a professional environment dedicated to accuracy and compliance.

$18.96-$19.75