Medical Billing Specialist - Premier Medical Resources

Premier Medical Resources is a healthcare management company headquartered in Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet.

The Medical Billing Specialist is responsible for analyzing patient's records and reviewing third-party coding for accuracy. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections.

ESSENTIAL FUNCTIONS:
• Reviews medical record documentation to ensure pertinent diagnoses are coded
• Utilizes ICD 10, CPT, HPCPS, operative reports, code diagnosis and modifiers according to coding guidelines
• Communicates effectively with all appropriate parties regarding missing information to ensure proper billing
submission
• Prepares and submit electronic and paper claims to insurance carriers and gov payers
• Manages the status of accounts and identify inconsistencies
• Resolves denials and rejections daily
• Handles electronic medical records (EMR) with proficiency and maintains accurate patient records
• Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES:
• Knowledge of workers compensation, insurance verification, patient responsibility and prior authorization process
• Knowledge of interpreting explanation of benefits (EOBs) and coordination of benefits (COB's) processing
• Knowledge of ICD-10 and CPT codes and procedures and basic business math
• Proficient in medical coding guidelines and regulations
• Proficient in electronic billing as well as the UB04 claim form
• Demonstrates task-oriented and organizational skills
• Ability to adapt with flexibility
• Strong attention to detail, being careful about detail and thorough in completing work tasks
• Ability to work independently by guiding oneself with little or no supervision
• Ability to communicate professionally with outside parties
• Knowledge of PC and ability to use Microsoft office suite (PowerPoint, word, excel)

EDUCATION AND EXPERIENCE:
• High School Diploma or GED
• Three (3) years of experience with medical claims/billing, medical billing cert in lieu of experience