Medical Policy Specialist jobs in El Paso, TX

Job Overview:
We are seeking a detail-oriented Medical Biller to join our team. The ideal candidate will be responsible for submitting medical claims to insurance companies and ensuring timely reimbursement.

Duties:

• Reviews, generates, and processes patient encounters for Patient Financial Services department. Reviews the patient care report (PCR) for clarity of patient demographics, billing information, supporting documentation, and information surrounding the patient encounter prior to charging and coding the encounter for billing.
• Determines primary, secondary, and/or tertiary insurance sequences based on insurance coverage per patient.
• Assesses incoming ancillary records (signature forms, Physician Certification Statements, etc) and determines if they meet regulatory requirements and company policy
• Determines appropriate HCPC and ICD 10 codes based on the medical data and narrative furnished in ePCR (electronic Patient Care Report) and if additional medical information of ePCR is needed to bill accordingly
• Review and verify accuracy of billing data and revise any errors
• Prepare and submit claims to insurance companies
• Follow up on unpaid claims within standard billing cycle timeframe
• Utilize medical collection systems to track and collect payments
• Communicate with medical providers regarding billing and coding issues
• Maintain patient confidentiality in compliance with HIPAA regulations

Qualifications:

• High school diploma or equivalent; associate's or bachelor's degree in healthcare administration, medical billing, or related field preferred.
• Certification in medical billing and coding (e.g., CPC, CCS-P) highly desirable.
• Proficiency in medical terminology, anatomy, and physiology.
• Knowledge of insurance policies, procedures, and billing guidelines.
• Strong attention to detail and accuracy in data entry and record-keeping.
• Excellent communication and interpersonal skills for interacting with patients, insurance companies, and healthcare providers.
• Ability to prioritize tasks, meet deadlines, and work independently or as part of a team.
• Familiarity with electronic health records (EHR) and medical billing software.

Job Type: Full-time

Pay: $16.00 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Office

Ability to Relocate:

• El Paso, TX 79901: Relocate before starting work (Required)

Work Location: In person