Medical Billing Specialist jobs in Jamestown, NY

Medical Billing Specialist reviews and verifies medical bills and invoices with accounts receivable ledger and patients. Ensures record accuracy, follows up, and makes necessary revisions. Being a Medical Billing Specialist processes changes in information system to support accurate and efficient billing process and financial close. Follows proper medical and insurance claim processes. Additionally, Medical Billing Specialist typically requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Medical Billing Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Medical Billing Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

Recently Added Medical Billing Specialist jobs

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Home Medical Equipment Billing Specialist
  • Penn Highlands Healthcare
  • Saint Marys, PA FULL_TIME
  • Overview:
    Penn Highlands Healthcare has been awarded on the Forbes list of Best-in-State Employers 2022. This prestigious award is presented by Forbes and Statista Inc., the world-leading statistics portal and industry ranking provider.

    AS THE HOME MEDICAL EQUIPMENT BILLING SPECIALIST,     you'll be under general supervision of the Billing Manager, the DME (DURABLE MEDICAL EQUIPMENT) Biller performs a variety of complex clerical and accounting functions for patient billing. Will be responsible for billing all payors for any DME item and rental items by verifying sales order information, obtaining authorization, if necessary, while following CMS Guidelines. Effectively manages all aspects of individual Revenue Cycle Management, including resolution of a variety of patient accounting problems. Issues and logs Certificates of Medical Necessity and follows up on unpaid claims by contacting any necessary entities. May handle cash items and accounts receivable posting. Must deliver empathetic and respectful customer service regarding our patients’ financial situation.

    Has duties of:

    • Ability to effectively use Brightree
    • Knowledge and proficient on various payor portals
    • Confirm all sales orders for various rental and purchase items of DME by verifying proof of delivery, ordering doctor, diagnosis, verify insurance and coinsurance percentages, address all coverage limitations and validation rules. Apply patient payments and upload tracking if applicable. Review prescriptions, progress notes or HSTs and edit any pending or expired CMNs (Certificates of Medical Necessity) to send to physician, mark sales order complete.
    • Create validation rules and coverage limitations alerts for CSRS to aid in sales order creation
    • Check electronic inbound fax for CMN’s, EOB (Explanation of Benefits), progress notes, etc.
    • Work daily individual Revenue Cycle Management types: billed claim follow-up, billing stops, CMN (Certificates of Medical Necessity) follow-up, denials, ERL follow-up, expired prior authorizations, timely filing, and unapplied payments.
    • Knowledge of the Medicare Appeals Process using portal i.e., redeterminations, etc.
    • Responsible for processing any updated information for claims to reprocess and ensure timely
    • Update patient benefit, demographic and insurance information as needed.
    • Maintain a strong knowledge of guidelines related to HIPAA, OIG Compliance, medical coding, and billing/reimbursement
    • Resolve customer account discrepancies
    • Monitor and maintain assigned accounts, customer calls, account adjustments, small balance write off, customer reconciliations and process patient and insurance refunds
    • Reconcile customer disputes regarding balances due
    • Assist Sales and other departments to resolve billing issues
    • Ability to be discreet and maintain the security of patient or customer information
    • Bill secondary claims electronically or by paper
    • Log/send/recert/revise CMN’s.
    • Bill all insurances, facilities, and non-insurance orders.
    • Check daily work in progress for outstanding orders and tasks
    • Complete timely billing audits/correspondence to insurance companies
    • Create sales order if appropriate especially for oxygen contents and oxygen maintenance checks
    • Communicate/obtain to personnel/supervisor/referral sources for non-compliance of documentation to ensure proper billing
    • Knowledge of NAVINET, Promise, UPMC and all CHC (Community Health Choices) portals and its tools
    • Knowledge of and verifying Same and Similar on Noridian JA portal
    • Logging prior authorizations and create PAR (Prior Authorization Request) tasks for re-authorizations
    • Maintain all price tables
    • Fix front end denials before claims transmission to clearinghouse
    • Bill pharmacy Medicare Part B drugs
    • Process internal prior AUTH’s for drugs dispensed at the pharmacy
    • Bill for maintenance and contents of oxygen if possible
    • Maintain and understand the patient pay portal and collection process in Collect Plus
    • Notify billing manager of any problems noticed with repetitive denials/contracting denials, software issues, etc.
    Qualifications:
    QUALIFICATIONS:
    • High school diploma (or equivalent) required
    • 3 years’ experience in insurance billing
    • Knowledge of electronic billing preferred
    • High attention to detail and able to multitask
    • Meets company minimum standard of Background Check
    • Comply with Company Employee Manual
    • Comply with company policies, procedures, and compliance.
    • Comply with all company, state, and federal policies, laws, and regulations, including HIPPA
    • Maintain positive attitude and conduct yourself in a professional, ethical, and knowledgeable manner toward supervisor, patients, referral sources, co-workers, colleagues, subordinates, and members of the public: everyone
    • Report to work regular, timely and gives advanced notice to supervisor for time off
  • 1 Month Ago
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C
Billing Specialist
  • Corry Memorial Hospital
  • Corry, PA FULL_TIME
  • Job Summary: To perform services necessary to complete efficient and accurate insurance processing for all patients in compliance with LECOM Health Corry Memorial Hospital policies and procedures. Cha...
  • 1 Month Ago
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L
Billing Specialist
  • LECOM Health
  • Corry, PA FULL_TIME
  • Job Summary: To perform services necessary to complete efficient and accurate insurance processing for all patients in compliance with LECOM Health Corry Memorial Hospital policies and procedures. Cha...
  • 1 Month Ago
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R
Medical Billing/Accounting Clerk
  • Recovery Options Made Easy
  • Olean, NY FULL_TIME
  • Are you interested in a career supporting people in your community in their mental health recovery? Join the team at Recovery Options Made Easy! Recovery Options Made Easy, is a nonprofit supported ho...
  • 1 Month Ago
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B
Patient Account Representative - Billing - Long Term Care
  • Bradford Regional Medical Center
  • Bradford, PA FULL_TIME
  • Patient Account Representative – Billing - Long term care Position Summary - To review, edit and submit bills to third party payers, health insurance carriers, workers compensation and automobile insu...
  • 23 Days Ago
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I
Part-time Medical Receptionist/Billing Clerk
  • Internal Medicine Office
  • Jamestown, NY PART_TIME
  • We are a busy Internal Medicine group serving the Jamestown, NY area.We are seeking a part-time office staff to join our team. A successful candidate must be able to handle a high-paced office, multi-...
  • 26 Days Ago
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0 Medical Billing Specialist jobs found in Jamestown, NY area

About Jamestown, New York

Jamestown is a city in southern Chautauqua County, New York, United States. The population was 31,146 at the 2010 census and was estimated at 29,591 in 2017. Situated between Lake Erie to the northwest and the Allegheny National Forest to the south, Jamestown is the largest population center in the county. Nearby Chautauqua Lake is a freshwater resource used by fishermen, boaters and naturalists. Notable people from Jamestown include comedian Lucille Ball, U.S. Supreme Court justice and Nuremberg chief prosecutor Robert H. Jackson, naturalist Roger Tory Peterson, singer Natalie Merchant, and N...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Billing Specialist jobs
$40,768 to $47,906
Jamestown, New York area prices
were up 1.5% from a year ago
View detail

What does a Medical Billing Specialist do?

Medical Billing Specialist in Melbourne, FL
In some workplaces, a medical billing specialist may be known as a medical biller and coder, while in other workplaces medical biller and medical coder are two separate jobs.
December 31, 2019
Medical Billing Specialist in San Bernardino, CA
The claim is that gives will buy your earnings as a guaranteed biller even if you have no calculatorand the end combine you the best billing business will pay you find many.
December 05, 2019
Medical Billing Specialist in Columbus, MS
The Medical Biller will follow up later to make sure the bill is paid by the insurer.
January 31, 2020