Job Description

Job Description

Job Description

Position Summary:

The Medical Billing Specialist will actively participate to expedite all aspects of commercial and BWC claims from First Report of Injury to claim submission and all aspects in between. As a working member of Billing Operations, the Medical Billing Specialist is a key component of the HMA and HATS teams in providing excellent claims management.

Summary Primary Responsibilities –Billing Specialist:

1. Preview appointments for accurate insurance and case information and attachment, making corrections as appropriate
2. Verifying and/or obtaining approvals for services to be rendered
3. Communicate with patients regarding insurance processes via face-to-face interaction and/or telephone
4. Communicate with clinical staff (doctors, patient care coordinators, therapists) to recommend and obtain appropriate diagnosis(es) allowance(s) based on documentation
5. Review reports to ensure we have appropriate authorization before providing services. c
6. Monitoring unbilled insurance and BWC charges and taking action necessary to expedite clean claim submission no later than 60 days from date of service
7. Maintain patient confidentiality
8. Administrative support in all areas involving BWC and Commercial Insurance Claims
9. Special projects and other duties as assigned
10. Communicate weekly with Office Operations Coordinator

Qualifications:

1. Thorough knowledge of BWC guidelines and processes
2. Knowledge and understanding of BWC plans for ICD-10 conversion
3. Working knowledge of CPT and ICD required; surgical coding and orthopedic coding experience preferred; CPC preferred
4. Insurance billing experience preferred
5. Ability to prioritize own work and work of others
6. Excellent Customer Service
7. Excellent written and verbal communication skills
8. Strong personal computer skills (Microsoft Office and Windows)
9. Detail oriented
10. Highly dependable

We are well known independent experts in caring for orthopedic conditions and injuries the Central Ohio region. Our surgeons are fellowship trained, and offer both effective surgical, and practical non-surgical options.

Company Description

We are well known independent experts in caring for orthopedic conditions and injuries the Central Ohio region. Our surgeons are fellowship trained, and offer both effective surgical, and practical non-surgical options.\r\n\r\nCome join a team that people throughout Ohio and surrounding states trust for specialized care.

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