Medical Billing specialist

A Medical Billing Assistant in a primary care setting using MDOffice

Manager in Clarksville, Indiana, would have several key responsibilities to ensure smooth billing processes and proper reimbursement for services rendered. Below is a detailed list of responsibilities specific to this role:

• Verify Patient Details:
  Collect and verify accurate demographic and insurance information from patients.
• Update Insurance Information:
  Ensure that all insurance details are current and accurate in MDOffice
  
  Manager.

• ICD-10, CPT, and HCPCS Coding:
  Assign appropriate codes to diagnoses (ICD-10) and procedures/services (CPT/HCPCS) performed during patient visits.
• Accurate Documentation:
  Ensure that all procedures and treatments are properly documented and coded according to regulatory guidelines.
• Ensure Correct Billing:
  Validate that all billed services match the procedures provided and that no errors are made in coding.

• Verify Insurance Coverage:
  Confirm insurance eligibility and benefits before patient appointments through MDOffice
  
  Manager or other tools.
• Obtain Preauthorizations:
  If needed, obtain preauthorization from insurance companies for procedures, tests, or treatments.

• Generate Claims:
  Create and submit claims for services provided to primary care patients using M
• Electronic Claim Submission:
  Submit claims electronically to insurance companies for faster processing and reimbursement.
• Insurance Follow-up:
  Monitor the status of claims and ensure timely follow-up with insurance providers.

• Investigate Denied Claims:
  Review any claims that have been denied by insurance companies, identify reasons for denial, and take corrective actions.
• Submit Appeals:
  Prepare and submit appeals for denied claims, ensuring that all necessary information and documentation is included.

• Post Insurance Payments:
  Accurate post payments received from insurance companies into the patient’s account within MDOffice
  
  Manager.
• Patient Payments:
  Post patient payments and manage any outstanding balances, ensuring that all payments are recorded accurately.
• Reconcile Accounts:
  Reconcile patient accounts to ensure all charges, payments, and adjustments are correctly entered.

• ce claims, and outstanding balances.

• Send Statements:
  Generate and send patient statements for outstanding balances
• Billing Inquiries:
  Answer patient questions regarding billing, insuran.
• Assist with Payment Plans:
  Help patients set up payment plans when necessary and ensure timely payments.

• HIPAA Compliance:
  Ensure that all billing and patient information is handled in accordance with HIPAA regulations.
• Insurance Rules Compliance:
  Follow payer-specific billing rules and ensure compliance with insurance regulations.

• Accounts Receivable Management:
  Track and manage the aging of patient accounts, following up on unpaid balances and outstanding claims.
• Generate Financial Reports:
  Produce reports on practice revenue, outstanding claims, and account aging for the practice manager or physician.
• Track Denials:
  Keep track of claim denials and identify trends that need to be addressed.

• Coordinate with Clinical Staff:
  Work closely with doctors and clinical staff to ensure accurate documentation and timely submission of billing information.
• Maintain Patient Records:
  Ensure that patient records are updated regularly and that they comply with medical billing standards.
• Provide Billing Support:
  Assist with any other billing-related administrative tasks as required by the office manager or practice owner.

• MDOffice
  
  Manager Expertise:
  Proficiency in using MDOffice
  
  Manager's practice management and medical billing modules.
• Medical Billing Knowledge:
  Familiarity with ICD-10, CPT, and HCPCS coding, and the ability to apply them in primary care settings.
• Insurance and Payer Knowledge:
  Understanding of common insurance providers and their billing practices.
• Communication
  
  Skills:
  
  Ability to communicate clearly with patients and insurance companies regarding billing questions and issues.
• Attention to Detail:
  Ensuring all billing codes and documentation are accurate to prevent claim rejections.