13 medical billing specialist jobs found in McKeesport, PA

Medical Billing Specialist SPECIFIC RESPONSIBILITIES: Generate primary and secondary paper bills according to established procedures. Edit paper claims before mailing. Perform claim follow up on denials quickly and accurately from assigned payers to ensure revenues are received timely. Run 837 files according to established procedures. Resolve any validation issues Accurate and timely data entry into payer websites for original claim submissions and/or corrected claims submissions. Verify and post remittance from assigned payers. Re-bill accounts as necessary to ensure an open insurance receivable against which a payment can be applied. Thoroughly research questionable/unidentified payment in order to post properly or refund to payer per payer guidelines. Work with payers and subscribers to resolve issues and facilitate prompt payment of claims. Verify NAP issues and work to resolve. Identify and communicate to up-line delays effecting balancing issues, new codes, or adjustments....

Medical Billing Specialist (Revenue Cycle Management) – Bilingual Spanish Preferred This is not a Remote position; it is in the Office Monday - Friday. This is not an entry-level role and requires independent ownership of revenue cycle processes. Position Summary Reliant Healthcare Group is seeking an experienced Medical Billing Specialist with demonstrated Revenue Cycle Management (RCM) expertise. This role is responsible for managing AR, payer follow-ups, and claim resolution to ensure timely reimbursement. Essential Duties & Responsibilities Manage full Revenue Cycle Management (RCM) processes Verify insurance eligibility and benefits for commercial and Medicaid MCO payers Follow up on Accounts Receivable exceeding 30 days Review AR aging reports and resolve outstanding balances Post payments and perform account reconciliations Obtain and manage insurance authorizations Review and correct claims to prevent denials Interpret payer contracts and...

Overview The Medical Billing Specialist plays a key role in helping individuals access and maintain essential services by ensuring financial resources and coverage options are properly identified and utilized. This position works closely with individuals, families, and third‑party payers to determine eligibility, benefits, and available payment solutions. The specialist proactively identifies and resolves financial concerns and collaborates with Intake and Finance teams to prevent disruptions in service delivery. Key Responsibilities Assist clients in resolving financial concerns while delivering exceptional customer service. Notify clients of insurance coverage lapses and services not covered by their plans. Secure insurance benefits and financial assistance resources, including completion of required documentation. Provide financial counseling and connect clients with available community resources. Manage eligibility processes for sliding‑scale fees, grant‑funded programs,...

Responsibilities Generate primary and secondary paper bills according to established procedures. Edit paper claims before mailing. Perform claim follow‑up on denials quickly and accurately from assigned payers to ensure revenues are received in a timely manner. Run 837 files according to established procedures and resolve any validation issues. Accurately and timely enter data into payer websites for original claim submissions and/or corrected claims submissions. Verify and post remittance from assigned payers. Re‑bill accounts as necessary to ensure an open insurance receivable against which a payment can be applied. Thoroughly research questionable/unidentified payments in order to post properly or refund to payer per payer guidelines. Work with payers and subscribers to resolve issues and facilitate prompt payment of claims. Verify NAP issues and work to resolve them. Identify and communicate to up‑line delays affecting balancing issues, new codes, or adjustments....

Mon Yough Community Services is looking for an experienced candidate to handle healthcare billing responsibilities including claims submission, follow-up, and patient communication. The role requires a minimum of four years in accounts receivable, focusing on healthcare billing. The ideal candidate will possess excellent organizational and communication skills while ensuring confidentiality in their work. Proficiency in billing procedures and the ability to manage multiple tasks are essential for success in this position. #J-18808-Ljbffr

Ntt Data ServicesAt NTT DATA, we know that with the right people on board, anything is possible.The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence.By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here..

Orthos Inc is hiring a Billing Specialist to provide remote support. This role involves answering patient inquiries, managing insurance claims, and ensuring payment accuracy. The ideal candidate has at least 2 years of billing experience, particularly in orthopedic billing, and is proficient in understanding insurance processes and coding. Strong communication and attention to detail are essential for success in this position. Join us in enhancing healthcare operations through innovative solutions! #J-18808-Ljbffr

UPMC Corporate Revenue Cycle Coder III UPMC Corporate Revenue Cycle is hiring a Coder III to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. As the Coder III you will have all responsibilities of coder trainee, coder I, II plus the following: Monitor and responds to accounts on Pre-Bill edit and error reports. Assist with training other coders as requested. Perform PHC4 coding corrections; provides feedback to coders who made errors. Monitor the Daily Cirius Error report to ensure that there are zero accounts exceeding the expected completion timeframe. Review and respond to the Pre-Bill Edit report issues to ensure timely billing. Assist with special projects as requested. We are looking for coders with prior experience with interventional radiology and cardiology CPT coding to join the team. If you are ready to take the next step in your coding career, look no further! Responsibilities: Determine...

Position Overview Compliance Auditor – monitors and improves the quality of clinical and financial documentation related to the provision of patient services. Under general supervision, the Compliance Auditor compares clinical and financial records to ensure documentation supports patient charges, codifies findings, and assists in reporting, monitoring, and education. Responsibilities Performs audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills, validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding; determining that governmental and third‑party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy of coding and billing performance by individuals,...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.In addition, this role focuses on performing the following Health Information Management duties:Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment.The majority of time is spent in the delivery of support services or activities, typically under supervision.An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or...

Job Details Description Review medical records and clinical documentation to assign accurate and complete diagnosis and procedure codes. Apply knowledge of coding systems (ICD-10-CM, ICD-10-PCS, CPT, HCPCS) and coding guidelines (AHA Coding Clinic, CPT Assistant, etc.) to ensure proper code selection. Abstract and enter coded data into electronic health record (EHR) and hospital information systems for billing and reporting purposes. Ensure compliance with federal, state, and payer‑specific coding regulations and hospital policies. Work closely with providers and clinical documentation improvement (CDI) teams to clarify ambiguities or incomplete documentation. Maintain productivity and coding accuracy benchmarks as defined by the department. Support audits and quality reviews by coding leadership or external bodies. Assist with mentoring or training junior coding staff as needed. Stay updated on coding changes, regulatory updates, and continuing education requirements....

Medical Coder - Full Time In this role you will be: Review medical records and clinical documentation to assign accurate and complete diagnosis and procedure codes. Apply knowledge of coding systems (ICD-9-CM, ICD-9-PCS, CPT, HCPCS) and coding guidelines (AHA Coding Clinic, CPT Assistant, etc.) to ensure proper code selection. Abstract and enter coded data into electronic health record (EHR) and hospital information systems for billing and reporting purposes. Ensure compliance with federal, state, and payer-specific coding regulations and hospital policies. Work closely with providers and clinical documentation improvement (CDI) teams to clarify ambiguities or incomplete documentation. Maintain productivity and coding accuracy benchmarks as defined by the department. Support audits and quality reviews by coding leadership or external bodies. Assist with mentoring or training junior coding staff as needed. Stay updated on coding changes, regulatory updates, and...

The Healthcare Compliance Auditor Senior I plays a key role in supporting UPMC's compliance and regulatory oversight activities through the identification, assessment, and mitigation of healthcare compliance risks. Leveraging expertise in healthcare operations, reimbursement methodologies, and regulatory requirements, this position conducts auditing and monitoring activities and collaborates with clinical, operational, revenue cycle, and compliance stakeholders to promote adherence to regulatory requirements. This is a full-time position that works Monday through Friday during normal business hours. The role follows a hybrid work model, with a combination of remote work and on-site attendance at UPMC's USX office. If this sounds like the role for you, apply today! Responsibilities: Must have knowledge of medical terminology, HIM coding, and reimbursement methodologies. Has working knowledge of internal policies and external regulatory requirements (e.g., Medicare,...