Medical Policy Specialist researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Being a Medical Policy Specialist establishes the proper codes to use for claims processing. Responds to questions from medical staff and communicates details about policy and guidelines. Additionally, Medical Policy Specialist requires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. The Medical Policy Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Medical Policy Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Job Summary: We are seeking a skilled and detail-oriented Medical Biller to join our team. As a Medical Biller, you will be responsible for accurately coding and billing medical procedures and services, ensuring timely reimbursement from insurance companies and patients. Your role will contribute to the financial success of our medical practice by maintaining accurate records and efficiently managing the billing process. Responsibilities: - Review and verify medical records, ensuring accuracy and completeness - Assign appropriate medical codes (ICD-10, DRG) to diagnoses, procedures, and services - Prepare and submit claims to insurance companies electronically or by mail - Follow up on unpaid claims and denials, identifying and resolving any issues - Communicate with insurance companies to resolve billing discrepancies or obtain additional information - Coordinate with medical office staff to ensure accurate patient information for billing purposes - Process payments from insurance companies and patients, applying them to appropriate accounts - Maintain confidentiality of patient information in compliance with HIPAA regulations - Stay updated on industry changes and regulations related to medical billing Experience: - Proven experience as a Medical Biller or in a similar role - Strong knowledge of medical terminology, ICD-10 coding, and medical billing procedures - Familiarity with medical records systems and electronic health records (EHR) - Proficient in using billing software and tools - Excellent attention to detail and accuracy in coding and billing processes - Strong organizational skills with the ability to prioritize tasks effectively - Effective communication skills for interacting with patients, insurance companies, and healthcare providers We offer competitive compensation based on experience. If you are a dedicated professional with a strong background in medical billing, we would love to hear from you. Apply now to join our team!
Job Type: Part-time
Pay: $18.24 - $19.13 per hour
Expected hours: 15 – 30 per week
Benefits:
Schedule:
Work setting:
Work Location: Hybrid remote in Iowa Falls, IA 50126
Clear All
0 Medical Policy Specialist jobs found in Cedar Falls, IA area