Medical Billing Specialist

Administrative / Clerical

McLaren Oakland

Position Summary : Responsible for processing and submitting claims to insurance companies, verifying insurance coverage, and collecting, posting payments from patients and insurances. Verifies that transactions comply with department's policies and procedures and all applicable government and insurer regulations.

Essential Functions and Responsibilities as Assigned :

1. Prepares bills and invoices for medical services.

2. Verifies accuracy of billing data and resolves errors.

3. Obtains insurance and financial information from patients.

4. Obtains medical authorization for payment from insurers.

5. Updates records with payments from insurance providers and patients.

6. Reviews failed, billed, and rejected claims to find resolutions.

• Works with insurance companies to collect payment on medical bills and post to accounts.
• May update Medicare and Medicaid cost and bad-debt reports, billing, collection and other related information.

9. May work with providers to identify the appropriate codes in selecting the patients' care plans, associated orders for treatment and any co-morbid conditions. Provides continuous education on the appropriate documentation to support all codes captured by the providers in the electronic health record.

10. Answers patient questions regarding repayment methods and billing disputes.

14. May collect co-pays and other required fees at the time of patient admittance.

15. Acts as a liaison between insurance companies, health care providers and patients.

Qualifications :

Required : High school diploma or GED.

Preferred : One year of medical billing / coding experience. Medical billing education. Degree in health care administration, accounting, or related. Billing or coding certification.