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Careers & Job Opportunities

Medical Billing Specialist

Essential Duties & Responsibilities: 

  • Utilizes various hospital/physician systems to verify patient, billing and claim information for accuracy. 
  • Performs compliant primary/secondary, tertiary and re-bill billing functions, including electronic, paper and portal submission to government and/or commercial payers. 
  • Edits claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission. 
  • Responds timely to emails and telephone messages, as appropriate. 
  • Communicates issues to management, including payer, system or escalated account issues.
  • Participates and attends meetings and training seminars, as requested.  
  • Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards. 
  • Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments. 
  • Updates patient demographics/insurance information in appropriate systems. 
  • Monitors claims for missing information, authorization and control numbers (ICN//DCN). 
  • Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems. 
  • Secures needed medical documentation required or requested by third party insurance carriers. 
  • Maintains and respects the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure. 
  • Utilize provider billing manuals to obtain billing guidelines and requirements 
  • Import verification and escalation of import/export files 
  • Special Handling billing included not limited to interim bills, overlap review, redistribution of money for correct claim creation 
  • Resolve and research billing Rejections 

Qualifications:

  • 2+ years of medical collections/billing experience 
  • Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI 
  • Intermediate knowledge of third party billing guidelines 
  • Intermediate knowledge of billing claim forms(UB04/1500) 
  • Intermediate knowledge of payor contracts 
  • Working Knowledge of Microsoft Word and Excel 
  • Intermediate working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.).

Preferred Requirements & Competencies: 

  • Working knowledge of one or more of the following Patient accounting systems –  EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon 
  • Working knowledge of DDE Medicare claim system 
  • Knowledge of government rules and regulations 

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