Naruvi Hospitals
Urgently Required
Billing Specialists
Experience : 1 to 5 years
No of vacancies : 1
Job Description: Billing Specialists in a healthcare organization are responsible for accurately processing and submitting medical claims to insurance companies and patients. They play a crucial role in the revenue cycle, ensuring that services rendered are billed correctly, in compliance with healthcare regulations and insurance policies. This position requires attention to detail, knowledge of medical terminology and billing procedures, and the ability to navigate various billing software systems.
Key Responsibilities: Claim Preparation and Submission: Prepare and submit accurate and timely claims to insurance providers and patients, ensuring all necessary documentation is included.
Insurance Verification: Verify patient insurance coverage and benefits before services are rendered, confirming eligibility and obtaining any required authorizations.
Coding and Billing: Apply appropriate diagnostic and procedural codes to claims based on medical records and documentation, adhering to current coding standards.
Claim Tracking and Follow-Up: Monitor the status of submitted claims, following up on unpaid or denied claims, resubmitting claims as necessary, and communicating with insurance companies to resolve discrepancies.
Payment Posting: Process payments and adjustments to patient accounts upon receipt from insurers and patients, ensuring accurate account balances.
Patient Inquiries: Address patient billing questions, providing clear and comprehensive explanations of charges, insurance benefits, and payment options.
Compliance: Maintain knowledge of and compliance with billing regulations, healthcare laws, and insurance policies.
Education Qualifications: Educational Background: High school diploma required; post-secondary education or certification in medical billing and coding, healthcare administration, or a related field is preferred.
Experience: Previous experience in medical billing and coding, healthcare billing, or a related field. Familiarity with healthcare insurance policies and procedures is advantageous.
Skills and Competencies: Proficiency in medical billing software, strong understanding of medical terminology and healthcare billing processes, excellent organizational and communication skills, and attention to detail.
Certifications: Certification from recognized programs like the Certified Professional Coder (CPC) by the AAPC or the Certified Billing and Coding Specialist (CBCS) by the NHA can enhance job prospects and credibility.
Key Attributes: Detail-Oriented: Exceptional attention to detail is crucial for accurately processing billing and coding information.
Analytical Skills: Ability to analyze and interpret medical records and insurance policies to ensure accurate billing.
Communication: Strong communication skills to effectively interact with insurance companies, healthcare providers, and patients regarding billing matters.
Problem-Solving: Aptitude for identifying and resolving issues related to billing and insurance claims.
Adaptability: The healthcare billing landscape is constantly changing, so being able to adapt to new regulations and technologies is essential.
About the Role: Revenue Cycle Contributor: Directly impacts the organization’s revenue cycle efficiency by ensuring accurate and timely billing, which facilitates revenue collection.
Compliance Adherent: Plays a critical role in maintaining compliance with healthcare billing standards, coding guidelines, and insurance regulations, reducing the risk of audits and penalties.
Patient Liaison: Acts as a point of contact for patients navigating their billing statements and insurance coverage, enhancing patient satisfaction and trust.
Team Collaborator: Works closely with other billing department staff, healthcare providers, and insurance liaisons to ensure a seamless billing process.
Continuous Learner: Stays informed about changes in billing codes, insurance policies, and healthcare regulations to maintain accuracy and compliance in billing practices.
Billing Specialists are key players in the financial health of healthcare organizations, ensuring that services are billed accurately and efficiently, which in turn supports the organization’s ability to provide care.