Job Description

Job Description

Job Description

Job Title:

Medical Billing Specialist

Department:

Accounting

Location:

Ontario

Reports To:

Accounting Manager

FLSA Status:

Hourly

Remote Status:

In Office

Salary Range

$25 to $28 hour

Position Summary : Reporting to the Accounting Manager and a member of the accounting team, this position is responsible for handling billing processes, submitting claims to insurance companies, and following up on any outstanding invoices to ensure prompt payment. This role involves working closely with healthcare providers, patients/clients, and insurance companies to ensure that all billing-related activities are completed accurately and efficiently.

Essential Duties and Responsibilities : To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Claims Preparation and Submission:

• Prepare, review, and submit medical claims to insurance companies, Medicare, Medicaid, and other third-party payers.
• Ensure all claims are accurate and compliant with industry standards and regulations.

Billing and Invoicing:

• Generate and send invoices to clients for services rendered.
• Maintain detailed records of all billing transactions.

Payment Posting:

• Post payments received from insurance companies and clients.
• Reconcile payments and identify any discrepancies.

Follow-Up on Unpaid Claims:

• Monitor unpaid claims and follow up with insurance companies or clients as necessary.
• Resolve any issues that prevent timely payment, such as claim denials or rejections.

Compliance and Confidentiality:

• Ensure all billing activities comply with relevant laws, regulations, and policies, including HIPAA.
• Maintain patient confidentiality and protect sensitive information.

Reporting:

• Generate reports on billing activities, including aging reports, revenue cycles, and collection rates.
• Provide insights and recommendations to improve billing efficiency and reduce claim denials.

Competencies: To perform the job successfully, an individual should demonstrate the following.

• Achievement Focus - Demonstrates persistence and overcomes obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to accomplish goals.
• Business Ethics - Inspires the trust of others. Keeps commitments. Treats people with respect. Upholds organizational values. Works with integrity and ethically.
• Managing Customer Focus - Develops new approaches to meeting customer needs. Establishes customer service standards. Monitors customer satisfaction. Promotes customer focus. Provides training in customer service delivery.

Qualifications : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education:

• High school diploma or equivalent; an associate’s degree or certification in medical billing/coding is preferred.

Experience:

• Previous experience in medical billing or a related field is preferred.

Technical Skills:

• Proficiency in medical billing software and electronic health record (EHR) systems.
• Strong computer skills, including Microsoft Office Suite (Word, Excel, Outlook).

Communication Skills:

• Excellent verbal and written communication skills.
• Ability to communicate effectively with patients, healthcare providers, and insurance companies.

Analytical Skills:

• Strong attention to detail and accuracy.
• Ability to analyze billing data and identify trends or issues.

Problem-Solving:

• Ability to resolve billing issues and disputes.
• Strong organizational and time-management skills.

Work Environment : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The noise level in the work environment is usually low.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit. The employee is frequently required to use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand and walk. The employee must be able to occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision. The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Job Tags

Hourly pay,

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