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Grace Care Homes

Grace Care Homes - helping breakdown institutionalized housing for people with developmental disabilities

Prior Authorization/Billing Specialist

Location

New Jersey

Posted

102 days ago

Salary

$18 - $19 / hour

Seniority

Senior

English

Job Description

• Prepare and submit accurate insurance claims using DRG, CPT coding, ICD-9, ICD-10, and ICD coding standards. • Review and verify medical records for completeness and accuracy prior to billing. • Manage accounts receivable by following up on unpaid claims and patient balances through medical collection processes. • Utilize EMR and EHR systems to document billing information and update patient records efficiently. • Collaborate with medical staff to ensure proper documentation of services rendered with appropriate medical terminology. • Reconcile billing discrepancies and resolve claim denials promptly to ensure timely reimbursement. • Maintain organized records of all billing transactions, claims, and correspondence for audit purposes. • Stay updated on changes in medical coding regulations and insurance policies to ensure compliance.

Job Requirements

  • Proven experience in medical billing, medical office administration, or related roles.
  • Strong knowledge of DRG, CPT coding, ICD-9, ICD-10, ICD coding, and medical terminology.
  • Familiarity with EMR and EHR systems used in healthcare settings.
  • Experience with medical records management and medical collection procedures.
  • Ability to interpret complex medical documentation accurately for coding purposes.
  • Excellent organizational skills with attention to detail to ensure error-free billing processes.
  • Effective communication skills for collaborating with healthcare providers, insurance companies, and patients.
  • Prior experience working with medical coding standards and insurance claim submissions is highly desirable.

Benefits

  • $18.96-$19.75

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