Medical Billing Specialist

Job Type : Full Time

Number of Applicants

:

000+

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Job Description - Medical Billing Specialist

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Job Summary

The Medical Billing Specialists are responsible for organizing and maintaining patient health information. They sort and maintain patient medical data and history of treatment for various uses such as insurance reimbursement and inclusion in databases and registries. Medical Billing Specialists ensure health information is accessible but also secure from unnecessary access.

Essential Functions And Tasks

Establish and maintain security of medical records to ensure patient confidentiality on an ongoing basis.
Review patient records on a daily basis for accuracy, supply any missing information and ensure compliance with company policy and government regulations.
Access patient records as needed for review by other staff members.
Follow professional standards and meet requirements of local, state and federal regulations
Encode information accurately from scanned medical images.
Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
Reviewing patient bills for accuracy and completeness and obtaining any missing information.
Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.

Requirements

Education and Experience Requirements

Knowledge, Skills, and Abilities

Ability to multitask.
Accuracy and attention to detail.
Communication and interpersonal skills.
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Familiarity with CPT and ICD-10 Coding.
Effective communication abilities for phone contacts with insurance payers to resolve issues.
Customer service skills for interacting with insurance phone specialists regarding medical claims and payments Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
Problem-solving skills to research and resolve discrepancies, denials, and appeals.
A calm manner and patience working with insurance phone specialists when inquiring about claim status.
Knowledge of medical terminology likely to be encountered in medical claims.
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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