Advanced Medical Billing Job Description Template
As an Advanced Medical Billing Specialist, you will be responsible for overseeing and managing the end-to-end billing processes in a healthcare setting. Your primary focus will be on ensuring accuracy in coding, timely submission of claims, and optimizing revenue cycles to enhance financial performance. This role requires a deep understanding of medical billing standards, insurance regulations, and the ability to address complex billing issues.
Responsibilities
- Manage and oversee the full-cycle medical billing process.
- Ensure accurate coding of medical procedures and diagnoses.
- Optimize revenue cycles and improve financial performance.
- Submit and follow up on insurance claims promptly and accurately.
- Resolve billing discrepancies and handle inquiries from patients and insurance companies.
- Maintain up-to-date knowledge of medical billing standards and regulations.
- Generate regular reports on billing activities and financial performance.
- Collaborate with healthcare providers and administrative staff to streamline billing operations.
Qualifications
- Bachelor’s degree in Health Information Management, Healthcare Administration, or related field.
- Certified Professional Biller (CPB) or equivalent certification.
- Minimum of 3-5 years of experience in medical billing and coding.
- In-depth knowledge of medical billing standards, insurance regulations, and coding systems (ICD-10, CPT, HCPCS).
- Excellent attention to detail and strong analytical skills.
- Effective communication and interpersonal skills.
Skills
- Medical Coding (ICD-10, CPT, HCPCS)
- Revenue Cycle Management
- Insurance Claim Processing
- Billing Software (e.g., Epic, Cerner, AdvancedMD)
- Regulatory Compliance
- Data Analysis
- Problem-Solving
- Attention to Detail
Frequently Asked Questions
An Advanced Medical Billing specialist manages the complex billing processes for medical services, ensuring accurate insurance claims processing and patient billing. They handle the reconciliation of billing records, work with healthcare providers to resolve claim discrepancies, and maintain compliance with healthcare regulations. Their role is crucial in streamlining financial operations in medical facilities.
To become an Advanced Medical Billing specialist, individuals typically need post-secondary education in healthcare administration or a related field. Certification in medical billing and coding, like CPC or CCS, is often required. Gaining experience in medical billing and staying updated on healthcare laws and insurance regulations is crucial for advancement in this career.
The average salary for an Advanced Medical Billing specialist varies based on factors like location, experience, and employer size. Typically, professionals in this field can expect to earn a competitive salary reflecting their expertise in handling complex billing tasks and their understanding of payer reimbursement methodologies.
Qualifications for an Advanced Medical Billing role often include a degree in healthcare administration or a related discipline, alongside certifications such as CPC, CCS, or RHIA. Proficiency in medical billing software, familiarity with ICD-10 coding, and a strong understanding of HIPAA regulations are also important qualifications.
An Advanced Medical Billing specialist must possess strong analytical skills, attention to detail, and proficiency in medical billing software. They are responsible for accurately processing insurance claims, tracking billing data, addressing claim rejections, and ensuring compliance. Effective communication with patients and healthcare providers is crucial in this role.