Medical Billing Specialist

Under the direct supervision of the Billing Manager, the Medical Billing Specialist will be responsible for processing claims electronically and manually to various funding sources which include DDD/DES, Medicaid/ AHCCCS and commercial insurance payers. It is expected that all denied claims will be worked promptly with the goal of collecting 95 – 100% of all monies owed to the Company while strictly adhering to all HIPAA guidelines as well as CMS fraud and abuse requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Responsible for the preparation, submission, follow up and research of all claims assigned
• Preparation of “clean claims” for initial submission
• Work denied and RTP claims and report to Billing Manager weekly regarding status
• Work share with other specialists to provide backup for PTO and other absences
• Assist the clinical staff with billing issues, training, coding and authorizations
• Attendance at weekly meetings with clinical staff for the purpose of discussing and resolving any current or long-standing billing issues
• Communicates with other departments to troubleshoot and prevent errors
• Other duties as assigned

KNOWLEDGE, SKILLS AND ABILITIES:

Minimum Required:

• Advanced knowledge of medical billing practices including DDD, DES, AHCCCS, Medicaid and Commercial insurances obtained by hands on experience
• Knowledge of Electronic Billing
• Ability to think critically to troubleshoot issues from beginning to end to ensure proper and timely submissions and payments.
• Ability to communicate clearly and concisely both verbally and in writing including the use of proper grammar, spelling, punctuation; ability to speak with patients, payers and co-workers in a helpful and customer service oriented manner
• Ability to perform basic mathematical calculations and balance and reconcile figures
• Must not have any restrictions for physical work for which reasonable accommodation cannot be made
• Proficiency with Excel, Word and Outlook

WORK EXPERIENCE AND EDUCATION:

Minimum Required:

• 2 years medical billing experience in a medical setting such as a physicians’ office or medical billing office
• 3 years AHCCCS , DDD/DES billing and follow-up experience
• High School diploma or GED

Preferred:

• College coursework in business, accounting or related disciplines

Job Type: Full-time

Salary: $18.00 to $25.00 /hour

Experience:

• AHCCCS and DDD billing: 1 year (Preferred)
• medical billing: 2 years (Required)

Education:

• High school or equivalent (Required)

Language:

• bilingual spanish (Preferred)