Medical Billing Specialist III; A267410-3 Detoxification

General Summary

Leads daily activities involving billing claims to Medicaid, Medicare, and third party insurances. Submits claims electronically, ensures staff members are completing their daily tasks, and generates monthly reports.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by employees in this job. Employees may be requested to perform job-related tasks other than those specifically presented in this description.

• Submits claims electronically for different services for adjudication.
• Communicates claims denial and appeals and posts payments.
• Leads and guides the work of subordinate staff.
• Generates monthly reports for finance.
• Conducts internal audits of the department.
• Provides training on cash handling.
• Will be required to drive a City vehicle for City business use.
• Performs other duties as assigned.

• Modern office procedures and methods including computers and applicable software.
• English grammar, spelling, and punctuation.
• ICD-10, CPT, and HCPCS medical coding.
• Medicare, Medicaid, and private insurance guidelines.
• Health Insurance Portability and Accountability Act (HIPAA) guidelines.
• Medical terminology.
• Medical coding and billing.
• Basic accounting principles.

• Skill in organization and time management.
• Skill in performing a variety of duties, often changing from one task to another of a different nature.
• Skill in critical thinking.
• Skill in conflict resolution.
• Skill in data entry.
• Skill in analysis.
• Skill in basic math.
• Skill in customer service.
• Ability to communicate effectively, both orally and in writing.
• Ability to establish and maintain effective working relationships.
• Ability to meet schedules and deadlines of the work.
• Ability to maintain the confidentiality of information and professional boundaries.
• Ability to prepare clear and concise reports.
• Ability to build and maintain effective working relationships with others.
• Ability to communicate clearly and effectively both orally and in writing.
• Ability to maintain good planning and organizational skills.
• Ability to take and follow directions from supervisor.
• Ability to give directions to and gain compliance from assigned staff.
• Ability to perform strenuous work and routine work.
• Ability to maintain a valid Texas Driver License and a good driving record.
• Ability to project a positive and professional image of the City of Laredo.
• Ability to effectively communicate both orally and in writing in the English language and orally in the Spanish language.
• Ability to comply with all City of Laredo's policies and procedures.
• Ability to maintain good health and physical condition sufficient to permit the full performance of the duties of this position.

Physical Effort Requirements:
Office or similar indoor environment, relatively free from unpleasant environmental conditions or hazards. Exerting up to 10 pounds of force occasionally, a negligible amount of force frequently, and/or constantly having to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Work Environment Locations:
Never – Street environment, Construction site, Confined space, Warehouse environment. Seldom – Outdoor environment, Vehicles. Often – Office or similar indoor environment.

Exposures:
Never – Extreme cold, Extreme heat, Moving mechanical parts, Fumes or airborne particles, Toxic or caustic chemicals or substances, Loud noises (85+ decibels). Sometimes – Individuals who are hostile or irate, Individuals with known violent backgrounds, Communicable diseases.

Travel:
Never – Regional, National, International. Sometimes – Local.

• High School diploma or G.E.D. equivalency.
• At least three (3) years of experience in medical billing or related experience.

Proof of TB Test/Screening will be required to be presented prior to employment.

• Medical Billing & Coding Certification. Must attach a copy of the certification to your application.
• Valid Texas Driver License. If applicant holds an out-of-state license, a State of…