Medical Billing Specialist-Hearing & Speech Center

Medical Billing SpecialistThis position located in Knoxville, TN Job Summary/Essential Job Functions: The Medical Billing Specialist serves to maximize reimbursement for services provided in the clinics operated by the Department of Audiology & Speech Pathology. This position ensures medical claims are properly coded and billed timely and identifies and investigates billing problems to find, communicate, and implement solutions. This position assists in maintaining provider credentialing for network participation compliance. ResponsibilitiesEnsures compliance with medical coding and billing regulations. Verifies coding and prepares claims for submission to the clearing house. Completes electronic claims submissions and mails paper claims as needed. Maintains Tennessee Early Intervention System (TEIS) website. Ensures providers enter service logs timely, enter primary/secondary ins payments, and send claims to TEIS with a copy of the primary/secondary EOB. Ensures services billed to third-party guarantors are properly and timely reimbursed. Files appeals on denied claims with any additional data requested. Educates administrative and professional teams on all areas of billing and coding. Works with individual providers to address billing/coding concerns. Assists in maintaining provider credentialing with federal, state, and private guarantors; files applications for participation with federal, state, and private programs or insurance. Maintains knowledge of CPT and DX codes, regulations, provider information, and insurance changes. Performs other duties as assigned. QualificationsMinimum Requirements: Education: High School Diploma or GED. (Transcript Required) Experience: Two (2) years of experience in an office setting in medical billing using an electronic medical record and/or accounting system; OR a combination of experience and education to equal two (2) years. (Prior experience in audiology or speech pathology setting is preferred.) Knowledge, Skills, and Abilities: Excellent computer skills including competency in Microsoft Excel and Word and accuracy in typing and data entry. Experience with computerized patient management or accounting systems. Ability to interpret guarantor billing and coding guidelines including Medicare and TennCare. Knowledge of common insurance reimbursement practices. Excellent communication skills with the ability to maintain a friendly demeanor and exhibit tact and professionalism both in person and on the phone. Excellent organizational and time management skills.