Medical Billing Specialist

We are in search of a Medical Billing Specialist based in Aliso Viejo, California. This role is within the healthcare industry and offers a contract to permanent employment opportunity. The Medical Billing Specialist will be tasked with managing customer service and medical billing duties, ensuring the accurate and efficient processing of customer applications and records, as well as resolving inquiries.

Responsibilities:

• Accurately process customer credit applications related to medical billing.
• Maintain precise customer credit records.
• Address customer inquiries and resolve any issues promptly.
• Monitor customer accounts and execute appropriate actions when required.
• Generate and collect DME claims for submissions to patients and third-party payers, as a result of products and services delivered to patients.
• Perform collection follow up calls or emails on primary and secondary claims as well as patient balances.
• Obtain billing information from clients and generate daily claims.
• Track pending claims and obtain claim status by contacting the payer or using the payer portal.
• Review and edit all aspects of a claim, including patient demographics, diagnosis codes, signed doctor prescription, proof of delivery, and insurance information in MediSoft.
• Verify benefits and eligibility and inform accounts with patient information.
• Correct rejected claims and alerts on a regular basis.
• Prep account when a refund is due and pass the refund to the Accounts Payable Department. • Possess at least one year of experience as a Medical Billing Specialist or in a similar role
• Proficiency in Accounts Receivable (AR) management and Claim Administration
• Familiarity with EMR (Electronic Medical Records) and Medisoft
• Strong Customer Service skills, able to handle queries and complaints effectively
• Demonstrable experience in Medical Billing and Medical Collections
• Proven track record in handling Medical Claims and verifying Insurance Eligibility
• Knowledge of Basic Medical Terminology
• Understanding and adherence to HIPAA Compliance - Patient Privacy Rule
• Capable of multitasking, with strong organizational skills
• Excellent verbal and written communication skills
• Ability to work as part of a team and independently when required
• Proficient in Microsoft Office Suite, particularly Excel and Word
• High school diploma or equivalent; further education in Medical Billing or similar field will be a plus.