Medical billing specialist job description
This post includes 3 parts: duties list, job qualification and job description writing tips for Medical billing specialist in details. A com...
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This post includes 3 parts: duties list, job qualification and job description writing tips for Medical billing specialist in details. A complete job description concludes Medical billing specialist key duties/responsibilities, Medical billing specialist job qualifications (knowledge, education, skills, abilities, experience…KSA model) and other ones such as daily tasks, key activities, key/core competencies, job functions/purpose…
I. List of Medical billing specialist duties:
1. Responsible for charge entry and follow up of all clinical services including; E/M services, immunizations, laboratory, procedures, and DME.2. Perform audit/research of problems pertaining to billing and reimbursement of all services provided
3. Process all payments into the company billing system in a timely and accurate manner.
4. Identify and corrects patient account errors.
5. Research and writes up refunds / credit balances.
6. Handles secondary payor billing and charge posting.
7. Determines if all claims are paid inaccurately and works with payor to obtain proper payment.
8. Researches payor claim denials and applies proper coding logic to determine if denial is appropriate and provides physician with a weekly report of denials.
9. Reviews superbill to ensure that the appropriate diagnosis codes are used and makes changes or suggestions for changes as needed.
10. Along with other staff, follows up with patient owe balances. Examples include resending statements, sending dunning notices, and soft collection efforts via phone.
11. Compiles information needed to turn past due accounts to collections.
12. Maintains fee schedules for Medicare, fee for services, and all other contracted managed health care plans.
13. Keeps current with CPT, ICD-9/ICD-10 and HCPCS codes.
14. Adheres to HIPAA and OSHA guidelines and procedures.
II. List of Medical billing specialist qualifications
1. Formal education and certification in medical billing required, Certified Professional Coder preferred. Minimum of 3 years’ experience in a primary care setting required to apply.2. Experience in a primary care physician billing office required.
3. Experience in billing for the following services are required:
a. E/M codes
b. Waived laboratory testing (ie: strep tests, UAs)
c. In-office procedures (ie: joint injections, biopsies, colposcopy, EKGs, spirometry)
4. Experience with billing laboratory services and DME not required but preferred.
5. General understanding of basic accounting principles.
6. Proven ability to analyze patient accounts
7. Knowledge of medical terminology.
8. Knowledge of customer service concepts.
9. Ability to communicate clearly and positively.
III. Tips to write job description
1. Too-long job description:
Looking at a too-long job description can frighten the candidates off and drive the away. A job description, no matter how important the job is, should not be included in more than 3 pages. If one focuses on too many things at a time, he shall definitely lose focus on the main items and get overwhelmed by the remaining; So, keep it concisely.
2. Too-short job description:
While too-long can be a problem, too-short is more a problem. It will ruin the meaning of the job description. A too-short one means it lacks necessary details and therefore, the candidate will not be able to understand while reading it.
3. Listing unnecessary functions or job duties:
Just classifying these into the “others” category will save you a lot of effort and space. On the other hand, the job description will become more dilute and easy to be neglected.
4. Key functions
Not listing key functions as required for the job can be a fatal mistake to a job description.
5. Grammar and spelling
Poor grammar and having spelling errors can ruin the job description, too. Never think that as you are the employer, you may have the right to make grammar or spelling errors while requires other not to. A job description with such errors is easily to be mistaken as a fake or ghost ads; as a result, the candidate will turn away from it.
6. Not specific enough:
Be specific and concise; if you don’t address the specific, then what the job description is for. It is for the candidate to understand just exactly what he needs to do or needs to have. Lacking details can confuse the candidates very well.
7. Not having the job description reviewed by others:
This is also a common mistake. One may be subject to bias, but more than one, especially with the help of those external advisor, the job description can be more perfect.
8. Using buzzwords or abbreviations:
In fact, it is not necessary at all to use such in a job description.
9. Using slang or legal words:
Just use common wording to communicate with others and don’t do anything extraordinarily.
10. Not updating the job description:
The same job may require different duties and responsibilities in different times, so, you cannot use the same job description for 2 different times.
