Our Medical Billing Specialist job description includes the responsibilities, duties, skills, education, qualifications, and experience.
About the Medical Billing Specialist role
A Medical Billing Specialist is responsible for accurately processing and submitting medical claims to insurance companies and other third-party payers. They verify patient information, enter data into medical billing systems, and review and appeal denied claims. They also manage patient accounts and contact insurance companies to obtain payment.
Role Purpose
The purpose of a Medical Billing Specialist is to ensure that medical services rendered to patients are accurately and efficiently billed to insurance companies, government agencies, and other payers. This involves collecting and entering patient information, submitting claims, processing payments, and managing accounts receivable. Medical Billing Specialists must have a thorough understanding of insurance policies, healthcare regulations, and coding systems to ensure accurate billing and payment of services. They must have excellent communication, organizational, and problem-solving skills.
Medical Billing Specialist Summary
The Medical Billing Specialist is responsible for providing accurate and timely medical billing services to patients and healthcare providers. They are responsible for reviewing patient records, coding medical procedures and diagnoses, and entering data into appropriate billing software. They must also be able to communicate effectively with providers, payers, and patients. The position requires strong organizational and interpersonal skills, as well as knowledge of medical terminology, coding, and billing processes. Additionally, a Medical Billing Specialist must be able to solve issues related to payment, reimbursement, and other issues.
Medical Billing Specialist Duties
- Review patient records to determine the services provided
- Verify accuracy of patient information and diagnoses
- Process and submit claims to insurance companies
- Follow up on unpaid claims to ensure payment
- Resolve any billing disputes or discrepancies
- Generate reports to track accounts receivable
- Provide customer service regarding billing inquiries
Medical Billing Specialist Skills
- Knowledge of medical terminology and CPT, ICD-10, and HCPCS coding
- Ability to accurately and efficiently process billing claims
- Proficiency in using medical billing software and databases
- Ability to analyze and interpret complex healthcare legislation
- Excellent problem solving and communication skills
Medical Billing Specialist Requirements
- Proficient in medical billing software
- Knowledge of coding and medical terminology
- Experience working in a medical office setting
- Excellent data entry and communication skills
- Able to handle multiple tasks
Personal Traits
- Attention to detail
- Organizational skills
- Knowledge of medical terminology