Medical Billing Specialist (KPO) Job Description Template
As a Medical Billing Specialist in a Knowledge Process Outsourcing (KPO) setting, you will be tasked with processing healthcare claims, ensuring conformity with billing regulations, and communicating efficiently with both clients and insurance companies. You will play a key role in managing account receivables and ensuring compliance with healthcare billing standards.
Responsibilities
- Process and submit medical insurance claims for healthcare providers.
- Verify accuracy of billing data and revise any errors.
- Communicate with insurance companies to resolve claim issues.
- Maintain records of patient insurance information and claims.
- Analyze and appeal claims that have been denied.
- Coordinate with medical staff to ensure correct billing codes are used.
- Ensure compliance with all healthcare regulations and billing requirements.
Qualifications
- Associate's degree in Health Information Management or related field.
- Certified Professional Biller (CPB) or similar certification.
- Minimum of 2 years experience in medical billing or coding.
- Familiarity with ICD-10, CPT, and HCPCS coding systems.
- Excellent organizational and analytical skills.
- Strong communication skills, both verbal and written.
Skills
- Medical billing software (e.g., Kareo, AdvancedMD)
- ICD-10 coding
- CPT and HCPCS coding
- Microsoft Office Suite
- Insurance claims processing
- Data entry
- Attention to detail
- Regulatory compliance knowledge
Frequently Asked Questions
A Medical Billing Specialist in a Knowledge Process Outsourcing (KPO) environment handles billing processes for healthcare providers. They manage patient account information, process invoices, and follow up on payments. They ensure accuracy in billing codes, adhere to insurance requirements, and improve cash flow by minimizing billing errors.
To become a Medical Billing Specialist in a KPO, candidates typically need a high school diploma or GED. However, obtaining a certification such as the Certified Billing and Coding Specialist (CBCS) or Certified Professional Biller (CPB) can be advantageous. Gaining experience in medical billing and proficiency in billing software and coding systems also enhances job prospects.
The average salary for a Medical Billing Specialist in a KPO varies based on factors like location, experience, and qualifications. Industry data suggests that individuals with certifications and a few years of experience tend to earn more. Salary packages may also include benefits such as healthcare, bonuses, and professional development opportunities.
Qualifications for a Medical Billing Specialist in a KPO include a high school diploma or equivalent. Additional certifications like the Certified Billing and Coding Specialist (CBCS) or the Certified Professional Biller (CPB) can significantly boost employability. Familiarity with medical billing software and knowledge of coding protocols like ICD and CPT are also essential.
A Medical Billing Specialist in a KPO should have strong analytical skills, attention to detail, and proficiency in medical billing software. Responsibilities include preparing invoices, maintaining patient records, and ensuring compliance with healthcare regulations. Effective communication skills and an understanding of insurance claims are also crucial for success in this role.