Billing Specialist I - Newport Beach, United States - Newport Orthopedic Institute

Newport Orthopedic Institute

Verified Company

Newport Beach, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

LOCATION:
Newport Beach, CA

***:Entry Level Healthcare Billing Specialist will be responsible for assisting with billing activities, including verifying patient insurance coverage, tracking benefits, eligibility, and obtaining authorization for medical services. The individual will begin training in billing processes including charge review, edit resolution in both the Practice Management system and clearinghouse, and billing related tasks. Additionally, the individual will be developed and have assigned tasks relating to the review of accounts receivables as part of revenue cycle management and revenue assurance.

ESSENTIAL DUTIES & RESPONSIBILITIES:

Verify patient insurance coverage and eligibility for medical services using electronic eligibility systems or by contacting insurance companies.
Track and update patient benefit information, including copayments, deductibles, and coverage limitations.
Obtain preauthorizations or prior authorizations from insurance companies for medical services, procedures, and treatments as required.
Communicate with healthcare providers, patients, and insurance companies to ensure timely authorization and approval of medical services.
Maintain accurate documentation of authorization requests, approvals, and denials in accordance with healthcare regulations and organizational policies.
Review patient medical records and treatment plans to obtain documentation that will support the medical necessity of requested services for authorization purposes.
Collaborate with healthcare providers, administrative staff, and insurance representatives to resolve authorizationrelated issues and ensure compliance with payer requirements.
Monitor and track authorization expirations and follow up on pending authorizations to prevent delays in patient care.
Assist with billing inquiries from patients, insurance companies, and other stakeholders, providing support and information as needed.
When assigned, assist in the billing processes including charge review, claim edit resolution, and other AR items including tasks for Revenue Cycle.
Participate in training and continuing education opportunities to enhance knowledge of healthcare billing regulations and procedures.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this position. Duties, responsibilities, and activities may change at any time with or without notice._

QUALIFICATIONS:

High school diploma or equivalent.
Prior experience in healthcare administration/reception, billing, or insurance verification required.

REQUIRED SKILLS:

Knowledge of medical terminology, healthcare billing processes, and insurance procedures.
Strong attention to detail and accuracy with the ability to organize and prioritize tasks effectively.
Excellent communication and interpersonal skills, with the ability to interact professionally with patients, healthcare providers, and team members.
Proficient computer skills and familiarity with electronic health record (EHR) and electronic practice management (EPM)/billing software required.
Ability to adapt to changing priorities and work effectively in a fastpaced environment.
Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.

PAY RANGE:
$20-$24 per hour