Medical Billing Specialist 2

Job Description

Full-time| M-F, 8am-4:30pm| PG7 | Weekly earned wage access is an option. 

*Pharmacist Technician License or recent Pharmacy Tech Licensure and Preferred 5 years or more Pharmacy tech experience in retail pharmacy or pharmacy billing is preferred.

Job Purpose or Objective(s):  As a Medical Billing Specialist 2, you will maintain an advanced understanding of coding and billing. Compile and submit claims to insurance companies for third-party reimbursement. Follow up on denials. You will report to Medical Billing Management.

 

Primary Tasks

  • You will prepare and submit claims to payers either electronically or by paper
  • Correct claims for re-submission in multiple systems
  • Reach and maintain department productivity and quality goals
  • Use methods such as phone, email, and regular mail to communicate with staff, patients, and insurance companies to resolve billing issues.
  • You will research overpayments, underpayments, payment denials due to rejections and reviews pending claims.
  • Billing Non- CDIB patients would require verifying payments and adjustments, prints monthly statements for the non- CDIB holders and Talihina Community Clinic.
  • Work in multiple systems to follow up on denied claim to resolve issues before claims are processed untimely.
  • Download files to batch and post payment to accounts manually or electronically.
  • Maintain strictest confidentiality; follow all HIPAA guidelines
  • Perform other responsibilities may be as assigned

Job Requirements

  • Great understanding of insurance policies and procedures
  • Knowledge of HIPAA guidelines/regulations
  • Three [3] years’ related experience