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Medical Billing Specialist

hace 2 meses

Xico, México Sagan A tiempo completo

**Job Summary**

Sagan is seeking a highly skilled Medical Billing Coordinator to join our team. As a Medical Billing Coordinator, you will play a critical role in ensuring the smooth operation of our revenue cycle process.

**Key Responsibilities:**

  • Review, verify, and adjust CPT and ICD coding before submission of professional claims.
  • Submit professional claims with appropriate modifiers and ICD pointers.
  • Post ERA / EOB payments and adjustments through PM software.
  • Review and research denials/underpayments and provide clinical arguments to appeal and dispute payer denials.
  • Monitor billed accounts to ensure outstanding/pending claims are paid in a timely manner.
  • Work upstream with client front office staff on identified issues to be fixed in the workflow.
  • Navigate insurance carrier websites such as Availity and Noridian.
  • Verify patient information and benefits.

**Requirements and Qualifications:**

  • 2+ years of experience in insurance billing is required.
  • Experience with EHR system GetHealthie.
  • The ability to navigate multiple PM systems is required.
  • Knowledge of insurance payers is required.
  • Certified Professional Coder (CBCS, CCS, CPC, RHIT, or equivalent) a plus.
  • Demonstrated understanding of the complete revenue cycle process from eligibility, authorization, and EHR system setup through billing and reimbursement.
  • Experience with automated billing systems and third-party clearinghouses, including the ability to interpret electronic billing/payment files. Knowledge of commercial insurance and other third-party billing processes.
  • Good problem-solving skills.
  • Strong customer service skills.
  • Team player with the ability to adapt to change and work effectively in a cross-functional team environment.
  • Ability to stay on task with limited supervision.
  • Capacity to prioritize multiple tasks using time management and organizational skills.
  • Excellent verbal and written communication skills.