Medical Billing Specialist

Job Description

Company Description

ModuleMD is a leading provider of innovative healthcare solutions, specializing in Electronic Health Records (EHR) and AI-driven tools designed to enhance clinical workflows. ModuleMD is dedicated to streamlining medical processes and improving patient care through cutting-edge technology. Our solutions are trusted by healthcare professionals seeking efficiency and accuracy. Join our dynamic team to contribute to advancing healthcare technology.

Role Description

This is a full-time remote role for a Medical Billing Specialist. The Medical Billing Specialist will be responsible for managing billing processes, handling insurance claims, processing denials, and ensuring accurate application of medical coding (ICD-10). This role also involves working with Medicare and other insurance providers to maximize revenue and ensure compliance.

Responsibilities

• Review, prepare, and submit accurate medical claims (electronic and paper) to insurance carriers. Ensure claims are clean to avoid rejections.
• Interact effectively and professionally with medical offices and their patients on behalf of ModuleMD providing information about their insurance payments and claims processing.
• Perform charge entry using CPT, ICD-10, and HCPCS codes.
• Provide medical offices with education on best practices in billing to improve overall success.
• Maintain strict compliance with HIPAA and all applicable federal / state regulations.
• Keep up to date with billing rules, insurance requirements, and payer policy changes.
• Review rejections and file corrected claims.
• Research and appeal denied claims.
• Access carrier websites for claim and eligibility information
• Interpret and process Explanation of Benefits.
• Monitor client accounts and provide weekly updates identifying issues and possible resolutions.
• Post payments
• Bill patients for responsible portions and have the ability to relay information regarding copays, deductibles and coinsurance.
• Answer patient calls regarding statements and balances.

Required Qualification

Preferred Experience

Skills Required

Benefits Offered

ModuleMD is an equal opportunity employer. We are dedicated to creating an inclusive, close-knit work environment where everyone is encouraged to be a part of the collaborative process and use individual strengths to shape their role at the company. Many of the benefits that come from working at ModuleMD are intangible, but we know how important standard benefits are. Here are some of the other benefits you can expect :