Overview

Join our dynamic healthcare team as a Medical Billing and Revenue Cycle Specialist specializing in correctional healthcare. In this vital role, you will manage the entire revenue cycle process, ensuring accurate billing, coding, and claims submission for incarcerated patients. Your expertise will help optimize revenue flow, improve claim acceptance rates, and support the delivery of quality healthcare services within correctional facilities. This position offers an engaging opportunity to apply your medical billing skills in a unique and impactful environment, contributing to both operational efficiency and patient care.

Responsibilities

• Review and verify medical records to ensure accurate coding using DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems.
• Prepare and submit healthcare claims efficiently using billing software integrated with EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems.
• Follow up on unpaid or denied claims through medical collections processes, working closely with insurance providers and internal teams to resolve discrepancies.
• Maintain detailed documentation of billing activities, medical records, and claim statuses to ensure compliance with healthcare regulations.
• Collaborate with healthcare providers to clarify documentation or coding issues that impact reimbursement.
• Utilize Microsoft Office tools to generate reports, track billing metrics, and analyze revenue cycle performance.
• Stay current on health insurance policies, regulations, and updates related to ICD coding standards to optimize claims processing.

Qualifications

• Proven experience in medical billing within a healthcare setting, preferably in correctional or institutional healthcare environments.
• Strong knowledge of DRG classifications, CPT coding procedures, ICD-9/ICD-10 coding standards, and medical terminology.
• Familiarity with medical collection practices and healthcare claims management processes.
• Proficiency in using billing software along with EMR/EHR systems for accurate data entry and claim submission.
• Excellent customer service skills with the ability to communicate effectively with insurance companies, providers, and patients.
• Solid understanding of health insurance policies, medical records management, and compliance regulations.
• Ability to analyze complex data sets using Microsoft Office tools for reporting purposes.

This role is perfect for motivated professionals eager to make a difference in correctional healthcare by ensuring efficient revenue cycle management while maintaining high standards of accuracy and compliance. Join us in supporting the health needs of underserved populations through your expertise!

Pay: $50,000.00 - $54,000.00 per year

Benefits:

• Flexible schedule

Work Location: Remote