Overview
Insurance Billing Specialist For MCO Jobs in Winston-Salem, NC at Nancy’s home care of the Carolinas
Job Summary
We are seeking a dedicated and detail-oriented Insurance Billing Specialist for Managed Care Organizations (MCO). The ideal candidate will possess a comprehensive understanding of medical billing processes, insurance claims, and coding systems relevant to managed care. As an integral part of our healthcare administration team, you will be responsible for ensuring accurate billing, efficient claims processing, and effective communication with payers. Your expertise will help streamline revenue cycle management and support the delivery of quality healthcare services.
Duties
- Review and verify insurance claims for accuracy and completeness, ensuring compliance with payer requirements and medical documentation standards.
- Prepare and submit claims using appropriate coding systems such as CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) classifications.
- Monitor claim status and follow up on unpaid or denied claims to facilitate timely reimbursement.
- Collaborate with healthcare providers to clarify billing information and resolve discrepancies in medical records or documentation.
- Maintain detailed records of billing activities, claim submissions, adjustments, and collections within electronic health record (EHR) or electronic medical record (EMR) systems.
- Stay current with changes in medical coding regulations, insurance policies, and managed care guidelines to ensure compliance.
- Assist in medical collections efforts by communicating effectively with payers and patients regarding outstanding balances.
- Support the training of new staff members on billing procedures, coding updates, and system usage to promote team proficiency.
Skills
- Strong knowledge of medical billing procedures within managed care environments, including claim submission workflows.
- Proficiency in CPT coding, ICD-9/ICD-10 coding systems, DRG classifications, and medical terminology.
- Experience working with EMR/EHR systems for billing and record management purposes.
- Familiarity with medical records management and documentation standards necessary for accurate claim processing.
- Excellent attention to detail to identify errors or discrepancies in billing data before submission.
- Effective communication skills for liaising with healthcare providers, insurance payers, and patients.
- Ability to adapt quickly to regulatory changes in medical coding and insurance policies related to managed care organizations. Join our team as an Insurance Billing Specialist for MCOs where your expertise will directly impact the efficiency of healthcare reimbursement processes while supporting quality patient care through precise billing practices!
Pay: $16.00 per hour
Benefits:
- Health insurance
- Paid time off
Work Location: In person
Title: Insurance Billing Specialist For MCO
Company: Nancy’s home care of the Carolinas
Location: Winston-Salem, NC
