Medical Billing and Aging Specialist (Full Cycle)

at Complete HealthCare Solutions, Inc.
Location Uniontown, OH
Date Posted November 22, 2019
Category Default
Job Type Full-time


The Medical Billing & Aging Specialist position processes billing to insurance companies.  Includes entry of charges, payment posting, adjustments, pursues collection of all claims until payment is made by insurance company  and patient (aging) and performs other work associated with the full-cycle billing process.

  1. Prepares and submits claims to third-party insurance carriers either electronically or by hard copy billing.
  2. Secures needed medical documentation required or requested by third party insurances.
  3. Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
  4. Processes rejections by either making accounts private and generating a notice of rejection to patient or correcting any billing error and resubmitting claims to third-party insurance carriers.
  5. Works with client to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
  6. Makes accounts self-pay and notify patients when claims have not been paid after time frames in established accounts receivable policy.
  7. Keeps updated on all billing and benefit changes for third-party insurance carriers.
  8. Posts third-party insurance remittance advices.
  9. Monitors claims for missing information and authorization/control numbers.
  10. Maintains confidentiality of all information.
  11. Completes work within authorized time to assure compliance with departmental standards.
  12. Keeps updated on all third-party billing requirements and changes for insurance types within the area of responsibility.
  13. Evaluates and presents insurance billing requirement changes to department, as well as client as necessary.
  14. Works with manager and/or management on special projects as assigned.
  15. Demonstrates knowledge of, and supports, billing office mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
  16. Performs other duties as required.

Required Education / Experience

  1. Post high school courses and/or associates degree related to medical insurance billing, and medical terminology.
  2. Five plus years of prior experience in billing of third-party insurances for primary care physician or related specialty.
  3. Knowledge and proficiency in full-cycle billing requirements
  4. Medical Billing software applications
  5. Certification in Medical Billing, Medical Coding and/or Medical Assisting preferred.