Medical Billing Specialist -Trainer

Description :

Summary : The primary focus of this position will be as a medical billing specialist and being able to carry out all the duties related to that position. As a medical billing specialist this position participates in the administration of the processing and collection of all insurance claims and assists patients with inquiries regarding their health care insurance coverage by performing the listed duties. A secondary and equally important focus will be on team training in medical billing which is both a daily function and at times will replace the specialist focus when bringing on new billing specialist team members (employees or students) and / or rolling out new medical billing processes or revisiting existing medical billing processes requiring a refresher. While responding to team questions which provides teaching moments and updates as a daily function it is through this daily communication that you will identify training needs and deficiencies in individuals and the team which will help with providing direction to the daily medical billing training process. As a medical billing trainer, the responsibilities include evaluating training needs both for individuals and the team as a whole, developing training curriculum, and delivering courses and information in a compelling way that increases employee skills and retention.

• Prepares and submits clean claims either paper or electronically in a timely manner to various insurance providers.
• Tracks and follows up on delinquent insurance collections and denials.
• Prepares and reviews patient statements for accuracy.
• Maintains and works accounts receivable report for billing.
• Identifies and resolves patient billing complaints.
• Performs various collections including contacting patients by phone and correcting and resubmitting claims to third-party payers.
• Responsible for posting payments and adjusting accounts per company billing guidelines.
• Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations.
• Adheres to Medicare and Medicaid guidelines.
• Works with insurance providers to expedite the collection process and ensure any pre-authorization requirements are met.
• Reviews accounts for possible assignments and makes recommendations to the Billing Supervisor and prepares information for the collection agency.
• Responsible for facility billing.
• Responsible for processing refunds to insurance carriers. Notifies VP of refunds and creates adjustments on accounts.
• Responsible for return mail. Working with facilities, patients and insurance websites to obtain correct information.
• Responsible for verifying insurance coverage on claims prior to submitting them to carriers.
• Assists intake Department on insurance questions relative to orders or insurance verification
• Assess the training needs of individuals and the organization. Identifies training needs by evaluating strengths and weaknesses of individuals and teams.
• Design and develop training programs based on both the organizations and the individual's needs
• Assess training effectiveness to ensure incorporation of taught skills and techniques into employees work behavior
• Provide feedback to program participants and management
• Ensure adherence to established training procedures and guidelines. Periodically evaluate ongoing programs to ensure that they reflect any changes
• Performs other related duties as assigned.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements :

Education / Experience :

High school diploma or general education degree (GED); Medical billing certification, or six to eight years related experience and / or training; or equivalent combination of education and experience in the medical billing / training field.

Certificates and Licenses :

Medical billing certification

Knowledge, Skills and Other Abilities :

Oral communication skills

Written communication skills

Diplomacy

Customer relations

Customer service

Negotiations

Organization

Planning

Professionalism

Time management

Budgeting

Attention to detail

Ability to learn quickly

Decision-making skills

Problem-solving skills

Flexibility

Leadership skills

Ability to prioritize

Ability to interpret and use ICD-10 codes

Computer Skills :

To perform this job successfully, an individual should have knowledge of Microsoft Word and Microsoft Excel.

Reasoning Ability :

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Compensation details : 20-25 Hourly Wage

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