Mambo Seafood Restaurants
Medical Billing Claims Specialist
Mambo Seafood Restaurants, Southern Pines, North Carolina, United States, 28387
Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Medical Billing Specialist to our team. With twelve ambulatory surgery centers and twenty-three clinic locations across the State of Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state.
Job Duties
Audit and ensure claim information is complete and accurate.
Process claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
Accurately and timely bill HCFA 1500 claims.
Document files with appropriate information (e.g., date‑stamped, logged, signed).
Create logs for providers of pending medical encounters or encounters with errors.
Work with other billing staff and management to meet end‑of‑month closing deadlines.
Handle clearinghouse rejections, print, and mail secondaries.
Address inquiries from insurance companies, patients, and providers.
Apply knowledge of CPT, ICD‑10, HCPCS coding and modifiers.
Understand third‑party payers such as HMOs, PPOs, Medicare, Medicaid, and Worker’s Compensation.
Use ERAs, EOBs, and payer‑specific/LCD guidelines.
Understand health plan benefits (deductibles, copays, coinsurance) and eligibility verification.
Proficient with spreadsheets and word processing applications.
Qualifications
Minimum of 3 years’ experience with medical billing or revenue cycle in a medical setting.
Experience with Medicare, Medicaid, commercial insurance plans, workers’ comp, and personal injury cases.
Familiarity with claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
Knowledge of medical billing rules such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
Excellent knowledge of CPT coding, ICD‑10 coding, and medical pre‑certification protocols.
Excellent computer skills and familiarity with Microsoft Office.
Comfortable working in a growing, dynamic organization and able to navigate change.
Self‑motivated with ability to multi‑task, prioritize work in a fast‑paced, team environment.
Bachelor’s degree preferred.
Experience using eClinicalWorks preferred.
Experience with Pain Management preferred.
The position is full‑time with competitive salary, PTO, health benefits, and 401(k) match. The ideal candidate will be located in North Carolina.
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Job Duties
Audit and ensure claim information is complete and accurate.
Process claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
Accurately and timely bill HCFA 1500 claims.
Document files with appropriate information (e.g., date‑stamped, logged, signed).
Create logs for providers of pending medical encounters or encounters with errors.
Work with other billing staff and management to meet end‑of‑month closing deadlines.
Handle clearinghouse rejections, print, and mail secondaries.
Address inquiries from insurance companies, patients, and providers.
Apply knowledge of CPT, ICD‑10, HCPCS coding and modifiers.
Understand third‑party payers such as HMOs, PPOs, Medicare, Medicaid, and Worker’s Compensation.
Use ERAs, EOBs, and payer‑specific/LCD guidelines.
Understand health plan benefits (deductibles, copays, coinsurance) and eligibility verification.
Proficient with spreadsheets and word processing applications.
Qualifications
Minimum of 3 years’ experience with medical billing or revenue cycle in a medical setting.
Experience with Medicare, Medicaid, commercial insurance plans, workers’ comp, and personal injury cases.
Familiarity with claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
Knowledge of medical billing rules such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
Excellent knowledge of CPT coding, ICD‑10 coding, and medical pre‑certification protocols.
Excellent computer skills and familiarity with Microsoft Office.
Comfortable working in a growing, dynamic organization and able to navigate change.
Self‑motivated with ability to multi‑task, prioritize work in a fast‑paced, team environment.
Bachelor’s degree preferred.
Experience using eClinicalWorks preferred.
Experience with Pain Management preferred.
The position is full‑time with competitive salary, PTO, health benefits, and 401(k) match. The ideal candidate will be located in North Carolina.
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