Job Description:

We are looking for an experienced Medical Billing Specialist with expertise in pain management for out-of-network billing to join our team. The ideal candidate will have a strong background in medical billing procedures, including knowledge of coding systems, insurance claim processes, and reimbursement regulations specific to pain management services. The Medical Billing Specialist will play a critical role in ensuring accurate and timely billing for pain management procedures, maximizing revenue, and maintaining compliance with healthcare regulations.

Responsibilities:

• Review and analyze medical records for pain management services to accurately assign appropriate diagnostic and procedural codes (e.g., CPT codes) for billing purposes.
• Prepare and submit insurance claims electronically or by paper, ensuring compliance with payer requirements and regulations specific to pain management billing.
• Familiarity with CPT codes commonly used in Pain Management Procedures, Evaluation & Management (E/M) Services.
• Follow up on outstanding claims, denials, and unpaid accounts related to pain management services, and take appropriate actions to resolve issues and facilitate prompt reimbursement.
• Verify insurance eligibility and benefits for pain management procedures, obtain pre-authorizations as needed, and communicate with insurance companies to resolve billing inquiries.
• Maintain up-to-date knowledge of coding guidelines, insurance regulations, and reimbursement policies specific to pain management services to ensure compliance and optimize revenue cycle performance.
• Collaborate with healthcare providers specializing in pain management, clinical staff, and administrative personnel to address billing-related issues and improve billing processes specific to this specialty.

Education Required:

• High school diploma or equivalent required.
• Additional certification in medical billing and coding (e.g., Certified Professional Biller, Certified Coding Specialist) is preferred.

Requirements:

• Minimum of 2 years of experience in medical billing, with a focus on pain management billing, preferably in a healthcare setting specializing in pain management.
• Proficiency in medical coding systems, such as CPT, ICD-10, and HCPCS, and familiarity with billing software and electronic health records (EHR) systems specific to pain management services.
• Strong understanding of insurance claim submission and reimbursement processes specific to pain management, including Medicare, Medicaid, commercial insurance, and third-party payers.
• Excellent attention to detail, organizational skills, and ability to prioritize tasks in a fast-paced environment.
• Effective communication and interpersonal skills, with the ability to collaborate with multidisciplinary teams and interact professionally with patients and insurance representatives.
• Knowledge of healthcare compliance regulations, such as HIPAA, and commitment to maintaining confidentiality and integrity in handling sensitive patient information.

Other: 

• Competitive salary commensurate with experience.
• Bonuses & allowances (Note: Allowances will be unlocked after 3 or 6 months in the company according to your performance in the probation period).
• A positive work environment with opportunities for growth and advancement within the company.