Billing Specialist I

This is a fully remote position, open to applicants in United States.

📋 Description

• Utilize master billing guidelines and various process instructions to evaluate PCR for medical necessity, reasonableness, service level, ICD10 coding, and mileage accuracy.

• Examine patient medical records and related documentation.

• Input necessary data elements into the billing platform, such as ICD-9 codes, charges, and billing narratives.

• Ensure that all tasks are carried out in compliance with Quick Med Claims policies as well as applicable state and federal regulations.

• Achieve or surpass established productivity standards for the role.

• Accurately document accounts reviewed.

• Attach required documentation within the system or to paper 1500s as needed.

• Gather additional information from clients when necessary, such as HIPAA forms, pre-authorizations from insurance providers, and physician medical necessity forms to facilitate third-party claims submission.

• Assess billing documents in the billing platform using dates from patient care reports, physician medical necessity forms, and hospital face sheets.

• Validate claims both electronically and on paper.

• Monitor tags or workflows to guarantee timely validation of claims.

• Process all insurance claim forms in line with federal and state laws as well as departmental procedures.

• Ensure accurate billing in accordance with regulatory requirements and internal policies and procedures.

• Exhibit billing proficiency by achieving and maintaining billing accuracy scores that meet or exceed expectations during quality assurance and audit processes.

• Comply with all Digitech HIPAA privacy policies and procedures, ensuring the confidentiality and security of sensitive patient information at all times.

• Perform additional job responsibilities as assigned.

⛳️ Requirements

• Education: High School Diploma or equivalent.

• 1 – 2 years of experience in medical billing is preferred.

• Certified Ambulance Coder (CAC) certification is preferred.

• Demonstrated ability or willingness to obtain QMC Biller Certification upon employment.

• Must be able to type at a speed of 35 words per minute.

• Basic computer skills, including the ability to use multiple windows and programs simultaneously.

• Strong customer service orientation.

• Keen attention to detail and a focus on quality.

• Good organizational skills.

• Must possess adequate written and verbal communication skills.

• Ability to thrive in a fast-paced environment.

• Capacity to work with minimal supervision.

• Ability to independently manage all aspects of the job role, including required goals and business practices in a remote setting.

🏝️ Benefits

• Competitive salary based on experience.

• Comprehensive benefits package.

• 401(k) Plan.