Medical Billing​/Verifications Specialist

Medical Billing/Verifications Specialist

Join to apply for the Medical Billing/Verifications Specialist role at Texas Regional Physicians

This person is responsible for insurance verification, obtaining prior authorizations, bill insurance claims and follow-up.

• Obtain authorizations, referrals, GAP exceptions, and Single Case Agreements
• Manage and prioritize required approvals with consistent follow-up while constantly communicating with the team
• Provide clinical documentation to insurance companies to ensure timely authorization
• Initiate appeals for upfront denied authorizations and follow through until completion
• Check eligibility and benefits
• Electronic claims building and submission
• Chart and coding review
• Call patients when necessary to verify insurance information
• Read and analyze EOBs and ERAs
• Work claims rejects/denials, send corrected claims, submit appeals
• Stay up to date on CPT, ICD, and LCD guidelines
• Provide excellent customer service and professionalism to patients

• High school diploma or GED
• 2 years prior experience insurance verification or medical billing required
• 2 years prior experience in a medical related field required
• Ability to multi-task and remain focused while managing a high volume, time-sensitive workload
• Demonstrate excellent communication and customer service skills
• Detailed-oriented with strong organizational skills
• Understanding of payer medical policies and guidelines to manage authorizations effectively
• Familiarity with governmental and commercial insurance plans
• Knowledge of medical terminology related to multispecialty surgical procedures
• Excellent computer skills including Excel, Word and Internet use
• Reliable to work scheduled shifts with limited unplanned absences

Note:

This position is not remote and requires employees to travel to the work location.

• Entry level

• Full-time

• Health Care Provider

• Hospitals and Health Care

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