
Senior Medical Billing Specialist
3 weeks ago
Overview
The Senior Medical Billing Specialist plays a critical role in the healthcare revenue cycle, ensuring that medical billing processes are conducted efficiently and accurately. This position is vital to the financial health of the organization, as it directly impacts the revenue generation through correct billing practices, coding accuracy, and effective claims processing. The ideal candidate will possess extensive knowledge of medical billing regulations and compliance standards. They will serve as a resource for junior staff and collaborate with healthcare providers, insurance companies, and patients to resolve billing issues. This role involves maintaining up-to-date knowledge of industry changes, optimizing billing procedures, and implementing best practices for billing functions. In addition, the Senior Medical Billing Specialist will lead initiatives to enhance workflow and reduce billing discrepancies. The ability to communicate complex billing information to diverse audiences, along with strong analytical and problem-solving skills, is essential for success in this position.
Key Responsibilities
- Manage and oversee the entire medical billing process for multiple healthcare providers.
- Ensure compliance with federal, state, and insurance company regulations.
- Review and audit medical claims to ensure accuracy and completeness.
- Resolve billing discrepancies and address denials in a timely manner.
- Collaborate with healthcare providers to verify patient information and insurance coverage.
- Track and manage unpaid claims to optimize revenue cycle management.
- Collect and analyze billing data to identify trends and improve processes.
- Provide training and support to junior billing staff.
- Implement billing best practices and recommend policy improvements.
- Prepare financial reports related to billing operations.
- Communicate with insurance payers and patients regarding billing inquiries.
- Stay informed on industry updates related to medical billing and coding.
- Support audits and compliance reviews as needed.
- Assist in the development and enhancement of billing software and systems.
- Foster relationships with external stakeholders including vendors and insurance representatives.
Required Qualifications
- Bachelor's degree in finance, healthcare administration, or related field preferred.
- Minimum of 5 years of experience in medical billing or related field.
- Extensive knowledge of medical coding principles (CPT, ICD-10, HCPCS).
- Proficient in electronic health record (EHR) and billing software.
- Strong understanding of insurance reimbursement processes.
- Excellent written and verbal communication skills.
- Ability to handle sensitive information confidentially.
- Proven problem-solving skills in high-pressure situations.
- Strong organizational skills with the ability to multitask.
- Detail-oriented with a commitment to accuracy.
- Experience in training and mentoring staff.
- Knowledge of HIPAA regulations and compliance standards.
- Ability to work both independently and as part of a team.
- Certification in medical billing or coding (AAPC, AHIMA) preferred.
- Demonstrated ability to analyze data and make informed decisions.
- Flexibility to adapt to new processes and changing environments.
Not Applicable
Employment typeFull-time
Job functionHealth Care Provider
IndustriesHuman Resources Services
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