US Medical Billing Job Description Template
The US Medical Billing specialist is responsible for accurately processing medical claims, handling patient billing inquiries, and ensuring compliance with healthcare regulations. This role involves coding medical procedures, managing billing software, and working with insurance providers to resolve any discrepancies.
Responsibilities
- Process and submit medical claims to insurance companies.
- Code procedures using ICD-10, CPT, and HCPCS codes.
- Follow up on unpaid claims and resolve billing issues.
- Communicate with patients regarding billing questions and concerns.
- Maintain accurate records of patient billing information and transactions.
- Ensure compliance with state and federal regulations concerning billing.
- Verify insurance coverage and obtain necessary pre-authorizations.
- Collaborate with healthcare providers to optimize billing processes.
Qualifications
- High school diploma or equivalent; associate degree in healthcare administration or related field preferred.
- Minimum of 2 years experience in medical billing or healthcare finance.
- Certified Medical Reimbursement Specialist (CMRS) or Certified Professional Biller (CPB) is a plus.
- Proficiency in medical billing software and electronic health records (EHR) systems.
- Strong understanding of HIPAA and other healthcare compliance regulations.
- Excellent communication and customer service skills.
Skills
- ICD-10 Coding
- CPT/HCPCS Codes
- Medical Billing Software
- Electronic Health Records (EHR)
- Insurance Claims Processing
- HIPAA Compliance
- Microsoft Excel
- Attention to Detail
- Time Management
Frequently Asked Questions
A US Medical Billing Specialist is responsible for managing patient billing processes, which includes submitting claims to insurance companies, verifying patient insurance information, and coding medical procedures. They ensure accurate invoicing to facilitate timely reimbursements for healthcare services.
To become a US Medical Billing Specialist, individuals typically need a high school diploma or GED. Pursuing a certification in medical billing and coding from an accredited program can enhance job prospects. Relevant skills include attention to detail, proficiency in billing software, and understanding of healthcare regulations.
The average salary for a US Medical Billing Specialist varies based on experience, location, and education level. Entry-level positions may earn less, while specialists with advanced certifications or experience in large healthcare systems can earn higher wages. Additional benefits may include healthcare and retirement plans.
Typically, a high school diploma is required for entry-level positions. However, possessing a certificate or diploma in medical billing and coding is advantageous. Understanding of medical terminology, coding systems such as ICD-10, CPT, and HIPAA compliance are essential qualifications for this role.
A US Medical Billing Specialist should have strong analytical skills, attention to detail, and proficiency in medical billing software. Responsibilities include preparing and submitting billing data, resolving billing discrepancies, and ensuring compliance with healthcare regulations. Effective communication is crucial when interacting with insurance companies and medical staff.