Medical Billing Specialist – Collections

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Requirements:

• At least 3 years of experience in Medical Billing and Collections.
• Knowledge of medical billing codes, including CPT and HCPCS coding, claims modifiers, and ICD-10 diagnosis coding.
• Familiarity with Revenue Cycle Management (RCM) systems and Practice Management Systems (PMS).
• Understanding of various insurance coverages and claims, including Health, Workers' Comp, and Auto.
• Ability to read and interpret EOBs.
• Experience coordinating with insurance companies.
• Strong adaptability and quick learning ability.
• Proven efficiency and punctuality in task execution.
• Previous experience in Orthopedic, Spine Surgery, and Pain Management Specialty is a plus.

Responsibilities:

• Review/analyze EOBs, Remittance Advice, and Denials to resolve account receivables.
• Prepare and analyze aging reports.
• Utilize various channels, including payer portals and outbound calls, to collect receivables.
• Update claims corrections and upload required documents in clearinghouse portals.
• Identify underpayments, prepare appeal documents, and create batches for payment posting.
• Code claims using CPT and ICD 10 codes.
• Contact patients, providers, and payers for eligibility checks or claims follow-up.
• Identify billing errors and resubmit corrected claims.