Medical Billing Specialist

at NAVAJO COUNTY GOVERNMENT in Show Low, Arizona, United States

Job Description

Summary

Under close supervision, performs specialty medical office and clerical work of moderate to high difficulty, specifically as relates to coding/billing of Medicare, Medicaid and private insurances; performs related work as assigned.

Essential Job Functions

(Essential function, as defined under the Americans with Disabilities Act, may include the following tasks, knowledge, skills and other characteristics. This list of tasks is ILLUSTRATIVE ONLY, and is not a comprehensive listing of all functions and tasks performed by positions in this class.)

Receives, sorts, indexes, types, files and retrieves forms, correspondence, and documents.

Ensures records management for audit purposes and compliance.

Sends invoices and account updates to patients and issues receipts for payments.

Keeps accurate records of patient accounts and outstanding balances.

Receives, sorts, and tracks incoming payments/reimbursements.

Initiates and manages collection efforts on outstanding balances, including sending billing notices and following up via phone and making payment arrangements.

Navigates electronic medical records systems and various insurance/payor platforms.

Checks and completes records, forms and documents.

Receives and distributes HIPAA sensitive correspondence.

Operates a variety of office equipment.

Compiles required reports with supporting data that are complex in nature.

Maintains confidential medical records and files, paper, and electronic.

Responsible for insurance verification and records for medical billing.

Codes and submits accurate insurance claims to insurance companies for reimbursement in a timely manner according to patient’s policy terms.

Tracks and follows up on unpaid or denied claims, including researching reasons for denial and resubmitting corrected claims or appeal claims as needed.

Maintains billing software.

Knowledge and Skills

Knowledge of CPT, HCPCS and ICD 10 codes for diagnostic and procedural coding.

Knowledge of and competency in electronic medical records and billing software.

Knowledge of full adult and pediatric vaccine schedules, alternate schedules, catch-up schedules and rule exceptions; as well as vaccine storage and handling practices.

Knowledge of office equipment, web-based medical applications, billing software, and electronic medical records systems.

Knowledge of and compliance to HIPAA standards and practices, with emphasis on medical/billing law and ethics.

Knowledge of medical policy and procedures and provider standing orders.

Skill in medical terminology and medical office practices, to include billing and coding applications.

Skill in multi-tasking in a busy office environment with high level of customer service and ability to assist patients with appointment navigation to determine if clients receive services through grant funded programs, private insurance, or private pay status based on qualifying indicators, while understanding the unique considerations when billing for public health services.

Skill in general accounting practices and complex clerical functions for medical office and billing.

Skill in tracking and reporting data and activity levels.

Skill in effectively communicating verbally and in writing.

Skill in establishing and maintaining effective working relationships with employees, other agencies, and the public.

Desirable Qualifications

High School Diploma or G.E.D.; AND one-year general clerical experience.  Certificate in medical office &/or experience in medical office with history of medical terminology, medical billing and electronic medical records use preferred.  Bi-lingual preferred.