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Medical Billing Specialist

A-Line Staffing Solutions LLC
20 hours ago
Full-time
On-site
United States
A-Line staffing is hiring a Medical Billing Specialist in Harrisburg, PA. The Medical Billing Specialist would be working for a Fortune 500 Biomedical company. If interested APPLY NOW for IMMEDIATE consideration Medical Billing Specialist Job Details Pay Range: $22-$25/hour (based on experience) Location: Harrisburg, PA 17120 (100% Onsite to start with potential to convert to hybrid setup) Shift: Monday – Friday 8am-4pm with a 30-min lunch (37.5 hours per week) Education: High School Diploma or equivalent required. Medical Billing Specialist Responsibilities · Analyze Medical Assistance billing inquiries to determine claim accuracy and proper payment. · Investigate denied claims, identify causes, and explain denial reasons to providers based on Pennsylvania regulations and MA billing guidelines. · Review Remittance Advice statements and explain payment details, including adjustments and take-backs. · Provide proactive customer service to providers and recipients via inquiry lines, including guidance on proper billing practices and benefit understanding. · Evaluate claims for correct procedure codes, modifiers, and prior authorization requirements. · Determine eligibility for 180-day exception processing. · Assess recipient eligibility and covered services under Medical Assistance. · Assist recipients with reimbursement requests and educate providers on MA program requirements. · Review billing history to identify duplicate claims and prevent future denials. · Conduct dental history research as needed. · Identify issues requiring escalation to external agencies or the Bureau of Program Integrity. · Respond to inquiries from providers and recipients on a variety of topics. Medical Billing Specialist Qualifications: · High School Diploma / GED required. Degree or certification highly preferred. · 2 years of relevant healthcare experience in medical billing and coding, claims support, etc. · Strong Knowledge of Medical Assistance and billing processes · Basic computer proficiency, including familiarity with Microsoft Office applications If interested in this Medical Billing Specialist position, APPLY NOW to Chris Meyer for IMMEDIATE consideration Medical Billing Specialist Responsibilities · Analyze Medical Assistance billing inquiries to determine claim accuracy and proper payment. · Investigate denied claims, identify causes, and explain denial reasons to providers based on Pennsylvania regulations and MA billing guidelines. · Review Remittance Advice statements and explain payment details, including adjustments and take-backs. · Provide proactive customer service to providers and recipients via inquiry lines, including guidance on proper billing practices and benefit understanding. · Evaluate claims for correct procedure codes, modifiers, and prior authorization requirements. · Determine eligibility for 180-day exception processing. · Assess recipient eligibility and covered services under Medical Assistance. · Assist recipients with reimbursement requests and educate providers on MA program requirements. · Review billing history to identify duplicate claims and prevent future denials. · Conduct dental history research as needed. · Identify issues requiring escalation to external agencies or the Bureau of Program Integrity. · Respond to inquiries from providers and recipients on a variety of topics.