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)
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Luxurious Lab Testing LLC is a small business in Lawton, OK. We are professional, agile and professional.
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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. Your role will involve working with medical records, insurance claims, and payment systems to ensure timely reimbursement for healthcare services. Duties: - Review and analyze medical records to identify appropriate codes for diagnoses, procedures, and services - Assign ICD-9 or ICD-10 codes to ensure accurate documentation of patient conditions - Utilize medical terminology and coding systems to accurately translate medical information into standardized codes - Prepare and submit insurance claims electronically or by paper submission - Follow up on unpaid claims and denials to ensure proper reimbursement - Communicate with insurance companies, patients, and healthcare providers regarding billing inquiries or disputes - Maintain patient confidentiality and adhere to all HIPAA regulations - Stay updated on changes in medical coding guidelines and regulations Skills: - Proficient in medical terminology, coding, and billing systems - Strong knowledge of ICD-9 and ICD-10 coding principles - Familiarity with medical collections processes and procedures - Excellent attention to detail and accuracy in coding and billing practices - Ability to analyze medical records and apply appropriate codes - Strong organizational skills to manage multiple tasks and deadlines effectively - Excellent communication skills to interact with insurance companies, patients, and healthcare providers Note: This job description is not intended to be all-inclusive. The employee may perform other related duties as negotiated to meet the ongoing needs of the organization. Please note that all positions at our company are paid positions.
Job Type: Full-time
Pay: $16.99 - $17.78 per hour
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Work Location: In person
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