Medical Billing Specialist – American Health Partners
Job Summary
The Medical Billing Specialist for Nurse Practitioners is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process, and posting cash receipts.
Essential Job Duties
Extract and verify billing information from medical records
Ensure collection of past‑due balances; follow up as needed
Maintain accurate patient demographic and insurance information before submitting claims
Answer patient account inquiries and assist in establishing alternative payment plans as necessary
Maintain patient account records; settle third‑party payer issues as required
Receive and review daily reconciliation review (DAR) document for accuracy; enter charges into the Practice Management System (PMS)
Prepare and review patient statements prior to release through PMS
Ensure timely filing of all Medicare, Medicaid, and third‑party insurance claims
Balance daily charges; reconcile with reports within PMS
Collaborate with the revenue cycle manager and payers on denials/rejections
Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained
Perform other duties as assigned
Job Requirements
Comply with applicable legal requirements, standards, policies, and procedures including the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and the Federal False Claims Act
Report concerns and suspected incidences of non‑compliance immediately to the Chief Compliance Officer
Communicate professionally with patients and guarantors regarding balances or account information
Participate in required orientation and training programs
Cooperate with monitoring and audit functions and investigations
Participate in process improvement responsibilities
Meet productivity goals
Successfully complete required training
Handle multiple priorities effectively
Required Skills
Problem‑solving skills to manage a variety of concrete variables
Effective verbal and written communication skills
Ability to interpret instruction presented in a variety of situations
Strong organizational skills; ability to manage multiple projects simultaneously
Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
Ten key speed and accuracy
EQUAL OPPORTUNITY EMPLOYER
This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization, including recruitment, hiring, promotions, and termination.
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