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Medical Billing Specialist

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JOB SUMMARY:  Under close supervision, prepares and submits insurance claims; reviews and adjusts accounts to ensure accurate and thorough billing of claims. The following duties are intended to provide a representative summary of the major duties and responsibilities and ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification.  Incumbent(s) may not be required to perform all duties listed and may be required to perform additional, position-specific duties. 

REPRESENTATIVE DUTIESPrepares and submits insurance claims. Determines, corrects and submits billable claims. Completes insurance data for patient claims. Processes, researches and corrects accounts; verifies diagnosis and authorization codes; identifies liability and guarantors; reviews and adjusts account balances; interprets Explanation of Benefits (EOBs).   Posts payments and adjustments in billing databases; prepares batches for posting.  Creates, organizes, corrects, updates and maintains accounts on data spreadsheets using medical billing software. Tracks status and confirms receipt of claims. Performs other duties as assigned or required.  

KNOWLEDGE and SKILLS  ·         Knowledge of medical billing and accounting procedures and applications.·         Knowledge of commercial insurance and government reimbursement programs.·         Knowledge of basic medical terminology and clinic processes.·         Knowledge of reception, typing, computer operations, and filing. ·         Skill in operating a personal computer using a variety of software including medical billing applications. ·         Skill in tracking and accomplishing multiple tasks and assignments.·         Skill in establishing and maintaining cooperative working relationships with other employees.·         Skill in conducting successful telephone consultations and operating a multi-line office phone system. 

MINIMUM EDUCATION QUALIFICATION A high school diploma or GED equivalent. 

MINIMUM EXPERIENCE QUALIFICATIONNon-supervisory – Three (3) years of experience working in a medical office performing medical billing processes.  An equivalent combination of relevant education and/or training may be substituted for experience. 

MINIMUM PHYSICAL REQUIREMENTSThe following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job.    This position requires the ability to sit for long periods of time. ANMC is not a latex free environment.  Therefore, some latex exposure can be expected.