Medical Billing Specialist

Premier Medical Resources

Texas

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JOB DETAILS

SKILLS

Accidental Death and Dismemberment (AD&D), Accounts Receivable, Analysis Skills, Best Practices, Billing, Centers for Medicare and Medicaid Services (CMS), Claims Processing, Communication Skills, Content Management Systems (CMS), Corporate Policies, Current Procedural Terminology (CPT), Dental Insurance, Detail Oriented, Disability Insurance, Documentation, Electronic Medical Records, Employee Assistance Plan, Establish Priorities, Government, Health Plan, Healthcare Common Procedure Coding System (HCPCS), Healthcare Management, High School Diploma, ICD-10, Insurance Claims, Insurance Documentation, Leadership, Maintain Compliance, Medical Billing, Medical Coding, Medical Records, Medical Terminology, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Organizational Skills, Patient Care Authorizations, Presentation/Verbal Skills, Problem Solving Skills, Reconciliation, Regulations, Reimbursement, Revenue Management, Time Management, Trend Analysis, User Interface/Experience (UI/UX), Vision Plan, Writing Skills

LOCATION

Texas

POSTED

6 days ago

Revenue Cycle Management is looking for a Medical Billing Specialist to join our team!

**Hybrid opportunity after 90 days of in-person training** (2 days from home, 3 days in office)

SUMMARY: The Medical Billing Specialist is responsible for analyzing patient’s records and coding the patient’s records based on ICD-10 and CPT codes. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections.

ESSENTIAL FUNCTIONS:

Reviews patient accounts and supporting documentation to ensure all billable services and charges are captured accurately
Validates diagnosis and procedure codes on accounts for billing accuracy and payer requirements; escalates discrepancies for correction
Communicates with clinical, coding, and front-end teams to obtain or clarify missing or incomplete information
Prepares and submits accurate electronic and paper claims to commercial insurance carriers and government payers
Investigates and resolves claim denials and rejections, including appropriate corrections and resubmissions
Maintains accurate and up-to-date patient account information within the electronic medical record (EMR) and billing systems
Identifies trends or recurring issues impacting reimbursement and communicates findings to leadership
Ensures compliance with payer guidelines, company policies, and applicable regulations
Perform other related tasks as needed

KNOWLEDGE, SKILLS, AND ABILITIES:

Knowledge of medical billing processes, including insurance verification, prior authorization, patient responsibility, and workers’ compensation
Knowledge of explanation of benefits (EOBs), remittance advice, and coordination of benefits (COB) processing
Working knowledge of medical terminology and ICD-10, CPT, and HCPCS coding systems as they relate to billing accuracy
Knowledge of payer guidelines, including government and commercial insurance requirements, claims submission, and denial management
Proficient in electronic billing systems and claim forms, including HCFA Form CMS-1500
Experience with electronic medical records (EMR) and practice management systems
Strong analytical and problem-solving skills with the ability to identify and resolve billing discrepancies
High attention to detail and accuracy in reviewing and processing claims
Strong organizational and time management skills with the ability to prioritize tasks effectively
Ability to work independently with minimal supervision and adapt to changing priorities
Effective written and verbal communication skills, including the ability to communicate professionally with internal teams and external parties
Proficient in Microsoft Office applications, including Word, Excel, and PowerPoint

EDUCATION AND EXPERIENCE:

High School Diploma or GED
Three (3) years of experience with medical billing, accounts receivable, or revenue cycle operations
Medical billing certification in lieu of experience

BENEFITS:

3 Medical Plans
2 Dental Plans
2 Vision Plans
Employee Assistant Program
Short- and Long-Term Disability Insurance
Accidental Death & Dismemberment Plan
401(k) with a 2-year vesting
PTO + Holidays

Please visit our website for more information:

www.pmr-healthcare.com

Premier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data. Employment for this position is contingent upon the successful completion of a background check and drug screening.

About the Company

Premier Medical Resources

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