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Rheumatology Medical Biller Specialist (5+ Years of Experience)

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Job Description - Rheumatology Medical Biller Specialist (5+ Years of Experience)


Job Summary:
We are seeking an experienced Rheumatology Medical Biller Specialist with over 5 years of experience in medical billing and coding, specifically in rheumatology. The ideal candidate will possess in-depth knowledge of billing procedures, insurance guidelines, and coding for rheumatology-specific services such as infusions, diagnostic imaging, and lab tests. This role requires precision, organization, and a deep understanding of revenue cycle management to ensure accurate billing and prompt reimbursement.
Key Responsibilities:
  • Specialized Billing & Coding: Accurately process claims for rheumatology services, using ICD-10, CPT, and HCPCS codes for treatments like biologics, infusions, and diagnostic procedures.
  • Claims Management: Submit, track, and resolve unpaid or denied insurance claims, ensuring adherence to Medicare, Medicaid, and private insurance policies.
  • Prior Authorizations: Coordinate and secure pre-authorizations for medications and treatments commonly used in rheumatology practices.
  • Accounts Receivable Management: Monitor and manage patient accounts, post payments, and ensure timely follow-up on outstanding balances.
  • Insurance Verification: Confirm insurance eligibility and benefits for rheumatology-specific procedures and treatments.
  • Compliance & Regulations: Ensure compliance with HIPAA regulations and current billing standards, including knowledge of payer-specific guidelines.
  • Provider Communication: Collaborate with rheumatologists and other healthcare providers to resolve coding and billing discrepancies.
  • Reporting: Generate reports on billing trends, revenue cycle performance, and areas for optimization.
Qualifications:
  • Experience: A minimum of 5 years of medical billing and coding experience, with at least 2 years in rheumatology or a related specialty.
  • Certification: Certified Professional Coder (CPC), Certified Medical Reimbursement Specialist (CMRS), or Certified Coding Specialist (CCS) preferred.
  • Technical Proficiency: Proficient in EHR/EMR systems, medical billing software (e.g., Kareo, AdvancedMD, or similar), and Microsoft Office Suite.
  • Knowledge: Advanced understanding of rheumatology-specific billing codes, treatments, and procedures.
  • Skills: Strong attention to detail, problem-solving abilities, and excellent communication skills.
  • Location: Must reside in Texas and be available during Central Time business hours.
Original job Rheumatology Medical Biller Specialist (5+ Years of Experience) posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs.
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