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)
Our Mission, Vision, & Model of Care
At Union Community Care, our purpose is to spark equity through patient-led healthcare that welcomes and strengthens our communities by integrating body, mind, and heart.
We envision vibrant and healthy communities supported by inclusive healthcare that embraces each member’s unique culture, needs, and values, and emboldens them to make healthful choices that fuel their well-being and the well-being of others.
We believe in whole health. This means we address and heal disease but equally important, we work at the causes of the causes, the social ills that must be addressed to achieve true equity.
We listen, learn, and embrace the complex lives and unique strengths of our patients, and we work hard to break down all barriers to care. This means we look through a grassroots lens. We connect with our communities because we are our communities. Each of us is a neighbor, a friend, a family member, and together, we are a trusted community health center.
JOB SUMMARY
The Billing Specialist is an integral part of Union Community Care to ensure correct claims submission and payment of those claims. The Billing Specialist is also responsible for all other functions as assigned by the Director of Revenue Cycle.
SPECIFIC JOB DUTIES
1. Assist the Medical Charge Entry Billing Specialist to complete data entry processes of visits to ensure timely month end closing processes and claims processing.
2. Payment Posting for all Dental visits
3. Communicate with applicable staff regarding open medical claims to get resolved timely
4. Work claim holds, appeals and re-submission when necessary.
5. Assist with Payer claims processing issues
6. Create and submit Dental claims per payer requirements, either electronic or via paper.
7. Prepare Dismissals Letters for non-payment
8. Assist Insurance Verification Specialist to determine coverage for medical patients.
9. Communicate to staff of findings if patient is not eligible to be seen by Union Community Care staff.
10. Explain account balances to patients, reviewing sliding fee policy as appropriate, set up payment plans, and verify/update patient demographic information as appropriate.
11. Assists in various billing office positions as required
12. Perform other work-related duties as assigned
POSITION REQUIREMENTS
High School Diploma or G.E.D.
Excellent telephone communication skills
Good basic computer skills
Good basic math skills
English proficiency required
Good interpersonal skills
Honor patient confidentiality
ESSENTIAL FUNCTIONS
In order to fulfill the requirements of this position, duties 1-12 are considered essential functions of the job.
ORGANIZATIONAL INVOLVEMENT
This position is required to participate in mandatory all staff meetings, team meetings and trainings.
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