Medical Billing Audit Team Lead
Company: Premier Medical Resources
Location: Houston
Posted on: May 16, 2022
Job Description:
Job DescriptionPremier Medical Resources is in search of a team
member to join our Revenue Cycle Management as a Medical Billing
Audit Team Lead. This position is responsible for performing
quality reviews to validate the integrity of medical reviews and
other documentation under and over coded services, prepares report
of findings and meets with management to educate on and improving
coding practices.About Premier Medical ResourcesPremier Medical
Resources, LLC is a healthcare management company, headquartered in
NW Houston near the Jersey Village area. PMR provides services to a
network of healthcare clinics and hospitals around Texas. These
services include staffing, logistics, operations, human resources,
billing, accounts receivable, legal, IT, scheduling, and
more.ESSENTIAL FUNCTIONS
- Performs a comprehensive medical records review to assure the
presence of all component parts including patient and record
identification signatures, dates where required, and other
necessary data in the presence of all reports which appear to be
indicated by the nature of the treatment rendered
- Ensures all documentation is accurate and compliant with
federal laws in terms of composition
- Reviews payment denials, underpayments, and payment take backs
for appropriateness and guides resolution by resubmission to the
insurance carrier, patient billing, or appropriate adjustment
- Collaborates with the Medical Records Manager and the Medical
Coding/Billing Manager to identify opportunities for improvement
and efficiency
- Advises management to develop more effective policies and
procedures and communicate with third-party payers, which includes
insurance companies and government payers regarding medical coding
or billing issues
- Fulfills internal and external requests for outcome data,
including developing special reports
- Monitors and reinforce the organization's policies, procedures,
and ethical conduct
- Provides oversight and training to the staff in the Audit
DepartmentKNOWLEDGE, SKILLS, AND ABILITIES
- Knowledge with in and out of network insurances, Workers
Compensation, insurance verification, patient responsibility, and
process for prior authorization
- Knowledge of interpreting EOBs, posting payments, and adjusting
accounts appropriately
- Familiarity with ICD-10 and CPT codes and procedures
- Proficient in medical coding guidelines and regulations
- Working knowledge of medical jargon and anatomy
- Must be task-oriented and have organizational skills
- Strong attention to detail
- Ability to communicate professionally with outside parties
- Ability to adapt with flexibilityMINIMUM QUALIFICATIONS
- 2 years of medical office or facility setting experience
(required)
- 2 years of medical billing auditing experience (required)
- 2 years of insurance billing and coding experience
(required)
- 2 years of orthopedic or surgery experience as a biller
(preferred)BENEFITS:We are offering a comprehensive benefits
package including:
- 401(k) with employer contribution
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Short and Long Term Disability Insurance
- Employee Assistance Program
- PTO + Holidays
Job Posted by ApplicantPro
Keywords: Premier Medical Resources, Houston , Medical Billing Audit Team Lead, Healthcare , Houston, Texas
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