Medsphere Commercial

Medical Billing Specialist

Medsphere currently has an opportunity for an experienced Medical Billing Specialist in our Mayfield Heights (Cleveland), OH, and Chesterfield (St Louis), MO, office locations. The successful candidates will be responsible for posting all encounters and payments, collecting and managing account payments, submitting claims and reviews, and following up with insurance companies and patients.

Primary Position Duties

  • Process physician charges for office, hospital and nursing home services.
  • Process electronic and manual payments and adjustments from insurance companies and patients.
  • Prepare and submit clean claims to various insurance companies either electronically or on paper.
  • Review account status, making recommendations to the practice for collection turnover or account adjustment.
  • Evaluate patient’s financial status and establish payment plans.
  • Answer billing inquiries from patients, practice staff, and insurance companies.
  • Identify and resolve patient billing issues.
  • Maintain strict confidentiality in accordance with HIPAA guidelines and regulations.

Qualifications

  • From five to ten years’ of progressively responsible experience with medical billing and coding, ERA and manual payment posting, claim review and RCM policies and procedures.
  • Working knowledge of Medicare, Medicaid and Workers’ Compensation Part B claim processing and payment posting.
  • Ability to establish and maintain accurate and complete records concerning billing activity.
  • Strong understanding of and experience with HCPCS and ICD systems.
  • Excellent interpersonal skills to work with others to influence and gain cooperation.
  • Ability to work independently, with little direction required.
  • Ability to recognize, evaluate, and solve problems.
  • Strong verbal and written communication skills.
  • Extensive knowledge of the claims development process, as well as third party insurance program requirements.
  • Ability to handle a variety of tasks with speed, attention to detail, and accuracy.
  • Computer literate, experience with basic software packages, specifically Word, mail merge, and Excel.
  • Data entry capability (50 wpm).
  • Experience using AdvancedMD billing software a plus but not a requirement.

Education

  • High school diploma or GED. Some college coursework, coding coursework/certification is preferred.

These positions are in Medsphere’s Mayfield Heights (Cleveland), OH, and Chesterfield (St Louis), MO, office locations.

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