Prior Authorization/Billing Specialist

Job Description:

• Prepare and submit accurate insurance claims using DRG, CPT coding, ICD-9, ICD-10, and ICD coding standards.
• Review and verify medical records for completeness and accuracy prior to billing.
• Manage accounts receivable by following up on unpaid claims and patient balances through medical collection processes.
• Utilize EMR and EHR systems to document billing information and update patient records efficiently.
• Collaborate with medical staff to ensure proper documentation of services rendered with appropriate medical terminology.
• Reconcile billing discrepancies and resolve claim denials promptly to ensure timely reimbursement.
• Maintain organized records of all billing transactions, claims, and correspondence for audit purposes.
• Stay updated on changes in medical coding regulations and insurance policies to ensure compliance.

Requirements:

• Proven experience in medical billing, medical office administration, or related roles.
• Strong knowledge of DRG, CPT coding, ICD-9, ICD-10, ICD coding, and medical terminology.
• Familiarity with EMR and EHR systems used in healthcare settings.
• Experience with medical records management and medical collection procedures.
• Ability to interpret complex medical documentation accurately for coding purposes.
• Excellent organizational skills with attention to detail to ensure error-free billing processes.
• Effective communication skills for collaborating with healthcare providers, insurance companies, and patients.
• Prior experience working with medical coding standards and insurance claim submissions is highly desirable.

Benefits: $18.96-$19.75