Medical Billing Specialist
The Billing Specialist is responsible for the intake and processing of all provider claims adhering to established standards and practices. Identify Provider documents and claim demographics to prepare a complete and accurate record for review. Receive phone & email inquiries from providers and/or clients with questions regarding claims. Have an outstanding attention to detail, question things that do not appear correct, and possess a desire to succeed and progress quickly.
Read, interpret & enter client claim information into the Encompass system to properly complete core functions.
Prepare and analyze Billing for various visit types/procedures using appropriate CPT/HCPCS coding and achieving daily and monthly metrics
Review and comprehend the fee schedule calculations & savings output to clients with the ability to identify inconsistencies.
Identify any inconsistencies in documentation to ensure proper claim processing to our clients and providers.
Understand the Appeal/Reconsideration process.
Document/update information in cases with high degree of accuracy.
Provide phone support, email & mail communications with both clients & providers. Represents Encompass in a professional manner. Treats all customers, internal and external, in a courteous and cooperative manner.
Work closely with interdepartmental operations staff to effectively manage referrals.
Understand & comply with all HIPAA & SOC2 requirements necessary in working with designated PHI.
Perform additional support functions as needed.
Working hours: 8:00 AM - 5:00 PM
Data entry by touch
Exemplary Customer Service Skills
Proven ability to perform with a high degree of accuracy under tight deadlines.
Attention to detail, Highly Organized
Excellent analytical skills, communication skills and the ability to work independently as well as being a team player.
Ability to multi-task
Proficient in all MS Office and computer application systems
Excellent verbal and written communication skills
No Degree Required
Associate??s degree or equivalent number of years?? experience.
Customer service (with call center & healthcare experience a plus)
Minimum typing speed of 45 WPM.billing JD
Email updated resume to SAYDELIS.RODRIGUEZ@randstadusa.com
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