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Medical Billing Specialist
The Medical Billing Specialist focuses on the accurate processing and submission of medical billing documents for reimbursement. This position requires a thorough understanding of healthcare billing procedures and insurance processes to ensure compliance and timely reimbursement for services rendered.
Class Code:
FFS06P
Job Grade:
SGS05
Special Job Requirements:
Typical Functions:
Process and submit medical claims to insurance companies and government programs. Review medical records to ensure that billing codes and charges are accurate. Ensure compliance with healthcare regulations, insurance policies, and state laws. Communicate with insurance companies to resolve discrepancies and underpayments. Track the status of claims and follow up as necessary. Provide customer service related to medical billing inquiries.
Knowledge, Abilities, and Skills:
Knowledge of medical coding, billing, and reimbursement processes. Understanding of healthcare insurance policies and billing software. Strong attention to detail and accuracy. Excellent communication skills for interactions with insurance providers and clients. Ability to resolve billing discrepancies and issues effectively.
Minimum Qualifications:
A high school diploma or equivalent. One to two years of experience in medical billing or a related field. Certification in Medical Billing or Coding is preferred. Satisfaction of the minimum qualifications, including years of experience and service, does not entitle employees to automatic progression within the job series. Promotion to the next classification level is at the discretion of the department and the Office of Personnel Management, taking into consideration the employee’s demonstrated skills, competencies, performance, workload responsibilities, and organizational needs.
Required Certificates:
N/A OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.
Exempt:
N