Medical Billing Claims Specialist

Overview

Join to apply for the Medical Billing Claims Specialist role at Summit Spine & Joint Centers .

Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Medical Billing Specialist to our team. With twelve ambulatory surgery centers and twenty-three clinic locations across the State of Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state. We are looking for a motivated and hard-working Claims Processor who can join our growing team of professionals.

Responsibilities

• Audits and ensure claim information is complete and accurate.
• Claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
• Ensures accurate and timely billing of HCFA 1500 claims.
• Ensures that files are documented with appropriate information (i.e., date stamped, logged, signed, etc.).
• Creates logs for providers of pending medical encounters and / or encounters with errors.
• Work directly with other billing staff and management to meet end of month closing deadlines.
• Able to work with clearinghouse rejections, print, and mail secondaries.
• Address inquiries from insurance companies, patients, and providers.
• Understands CPT, ICD-10, HCPCS coding and modifiers.
• Knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc.
• Knowledge of ERAs, EOBs.
• Knowledge of payer-specific LCD guidelines.
• Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification.
• Must be proficient with spreadsheets and word processing applications.

Qualifications

The position is full time with competitive salary, PTO, health benefits and 401k match. The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where other members of the billing team are located.

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