Medical Claims and Billing Specialist
Company: Orthopedic Associates of Flower Mound, PLLC
Location: Flower Mound
Posted on: January 22, 2023
Job Description:
SUMMARY: Provides assistance with various healthcare services
following established policies and protocols. Proficient in medical
billing, coding and working insurance denials.
DUTIES AND RESPONSIBILITIES:
- Must be able to appeal denied claims
- Posting daily insurance payments for 12 providers if
needed
- Ability to verify patient benefits if needed
- Identify payment trends
- Monitor allowed amounts
- Follow-up with insurance companies on outstanding claims
- Work insurance refund letters
- Assist with medical record audits from various insurance
carriers
- Ability to communicate with clinical staff
- Ability to read and understand an explanation of benefits and
convey to patient
- Exhibits a high degree of courtesy, tact, and poise when
interacting with patients, families, and other healthcare
professionals.
- Adjusts to fluctuating peaks in patient flow, acuity, and other
operational demands while maintaining quality.
- Performs other related duties as assigned by management.
QUALIFICATIONS:
- High school diploma.
- 3+ years of insurance and medical billing experience
- Complete understanding of managed care products (i.e. PPO, HMO,
POS, MEDICARE, Workers Compensation, Medicare Replacement Plans,
Exchange Plans)
- Multi- tasking skills are essential
- Working knowledge of ICD 10 and CPT Codes
- Commitment to excellence and high standards
- Able to work collaboratively with multiple health professionals
in a busy and complex environment using tact, diplomacy, and
discipline.
- Ability to understand and adhere to established policies,
procedures, and protocols.
- Ability to manage priorities and workflow
- Proficient at reading and understanding explanation of
benefits
- Multi-tasking skills are essential
COMPETENCIES:
- Dependability - Follows instructions, responds to management
direction; Takes responsibility for own actions; Keeps commitments;
Commits to long hours of work when necessary to reach goals;
Completes tasks on time or notifies appropriate person with an
alternate plan.
- Judgement - Displays willingness to make decisions; Exhibits
sound and accurate judgment; Supports and explains reasoning for
decisions; Includes appropriate people in decision-making process;
Makes timely decisions.
- Problem Solving - Identifies and resolves problems in a timely
manner; Gathers and analyzes information skillfully; Develops
alternative solutions; Works well in group problem solving
situations; Uses reason even when dealing with emotional
topics.
- Professionalism - Approaches others in a tactful manner; Reacts
well under pressure; Treats others with respect and consideration
regardless of their status or position; Accepts responsibility for
own actions; Follows through on commitments.
- Quantity - Meets productivity standards; Completes work in
timely manner; Strives to increase productivity; Works quickly.
PHYSICAL DEMANDS AND WORK ENVIRONMENT:
- Occasionally required to stand
- Occasionally required to walk
- Continually required to sit
- Frequently required to utilize hand and finger dexterity
- Occasionally required to climb, balance, bend, stoop, kneel or
crawl
- Frequently required to talk or hear
- While performing the duties of this job, the noise level in the
work environment is usuallyvery quiet
- The employee mustoccasionally lift and /or move more than 5
pounds
The above is intended to describe the general content of and
requirements for the performance of this job. It is not to be
construed as an exhaustive statement of duties, responsibilities or
physical requirements. Nothing in this job description restricts
management's right to assign or reassign duties and
responsibilities to this job at any time. Reasonable accommodations
may be made to enable individuals with disabilities to perform the
essential functions.
Keywords: Orthopedic Associates of Flower Mound, PLLC, Flower Mound , Medical Claims and Billing Specialist, Other , Flower Mound, Texas
Didn't find what you're looking for? Search again!
Loading more jobs...