PedsOne - Medical Billing Specialist

PedsOne Medical Billing Specialist.jpg
  • Position Type: Regular/Full-Time
  • Location: 10 East Allen Street, Suite 100 Winooski, Vermont 05404

PedsOne medical billing specialists provide best-in-class billing services to pediatric practice clients. Billing specialists review claims for accuracy, oversee processing of claims to payers, resolve insurance company payments that are late, underpaid or denied, and work closely with providers, practice managers and staff to implement best practice protocols.

Responsibilities:

  • Learn and become proficient with the premiere pediatric system in the industry - Partner Billing System by Physician’s Computer Company (PCC).
  • Efficiently analyze insurance claims throughout the submission process insuring claims are accurately coded in a timely fashion and for optimum reimbursement and compliance.
  • Ensure that all claims reach the payers and independently resolve any issues (underpayments, denials, etc.) with the claim so that claims are paid fully and on time.
  • Consult with the practice manager, front desk staff and providers on a regular basis to implement and maintain quality assurance, optimal billing procedures and client satisfaction.

Requirements:

  • Minimum 3 years of medical billing experience.
  • Familiarity with the proper use of ICD-10, CPT, HCPCS coding rules.
  • Working knowledge of medical terminology, anatomy and physiology.
  • Knowledge of Medicare’s National Correct Coding Initiatives edits.
  • Proficient in office based computer programs - Word, Excel, Outlook, and Gmail.
  • Experience using the Internet to access payer websites for policies and rules as well as general research.

Ideal Candidate Characteristics:

  • Strong time/project management skills.
  • Strong attention to detail and follow through.
  • Passion to achieve excellence.
  • Works with a blend of quality, speed, and accuracy.
  • Thrives in an autonomous work situation.
  • Takes full ownership of both the successes and the failures of a task.
  • Has strong relationship building skills.
  • Is an effective and efficient problem solver.
  • Is good with numbers and accurate with data entry.
  • Has a polite and has a professional approach.
  • Is honest, open, sincere.
  • Fosters excellent customer service.
  • Appreciates being recognized and rewarded for excellent results.

Plus Experiences:

  • Primary care or Pediatric billing experience.
  • AAPC, CPC medical coder certification.