Medical Billing Specialist with EPIC - Physician Billing Experience | Onsite

Job Summary:

The Senior Medical Billing Specialist is responsible for the timely submission of technical or professional medical claims to insurance companies. This role involves verifying patient and billing information, editing claims for compliance, resolving denials, and communicating with both payers and internal teams.

Job Description

:• Utilize various hospital/physician systems to verify patient, billing, and claim information for accuracy

.• Perform compliant primary/secondary, tertiary, and rebill billing functions across electronic, paper, and portal platforms

.• Edit claims to meet payer-specific compliance requirements (electronic and hardcopy)

.• Respond timely to email and telephone messages as appropriate

.• Communicate claim issues to management, payers, system contacts, or escalated account owners

.• Participate in department training seminars and in-services to expand job knowledge

.• Serve and protect the hospital community by adhering to policies, procedures, and standards (federal, state, local, JCAHO)

.• Support the billing department and hospital reputation by accepting ownership of tasks and delivering value through performance

.• Update patient demographics and insurance details in appropriate systems

.• Monitor claims for missing info, automation flags, or control numbers (ICN/DCN)

.• Follow protocols for prioritization, deadlines, and notation accuracy

.• Secure needed documentation from payers or third-party sources

.• Maintain confidentiality of patient information in compliance with policy

.
Qualification

s:• Experience with claims management and rejection editin

g.• Familiarity with patient accounting systems such as EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, Allscripts, or Parago

n.• Experience identifying billing errors, correcting and resubmitting claims, and resolving denials or underpayment

s.• Familiarity with EOB, UB04, and CMS -1500 billing form

s.• Knowledge of ICD-10, CPT, HCPCS, and NCCI codin

g.• Demonstrates the ability to read, interpret, and apply payer contract

s.• Proficient in navigating healthcare information systems (EMR, Patient Accounting, Claim Scrubbers, etc.

).• Understanding of accounts receivable processes and third-party payer coordinatio

n.• Demonstrates the ability to use Internet Explorer, Microsoft Outlook, Excel, and internal email/calendar tool

s.• Exhibits a strong ability to work both independently and collaboratively within a tea

m.• Proven track record of meeting performance metrics and deadline

s.• Clear and coherent both written and verbal communications skills in English, to communicate effectively with with payers and team member

s.
Screening Criter

ia:• High school diploma or equivalent combination of education and work experien

ce.• Minimum of two (2) years experience in healthcare insurance billi

ng.• Proficient with EPIC specifically with Physician Bill

ing• Must have stable employment histo