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The Medical Billing Specialist is a key member of our team at RT Medical, responsible for ensuring accurate and timely processing of patient billing information, insurance claims, and payments. This role requires a strong understanding of medical billing procedures, insurance guidelines, and regulatory requirements in Ontario.
Key Responsibilities:- Billing and Coding:
- Accurate Data Entry: Enter patient billing information into our electronic health records (EHR) system with precision and attention to detail.
- Medical Coding: Assign accurate medical codes (ICD-10, CPT) to diagnoses and procedures, ensuring compliance with regulatory requirements.
- Verification and Review: Verify patient information for completeness and accuracy, ensuring that all necessary details are captured.
- Insurance Claims Management:
- Claims Submission: Submit insurance claims to appropriate payers, including provincial health insurance (OHIP & WSIB) and private insurers, ensuring timely and accurate processing.
- Claims Resolution: Follow up on unpaid or denied claims to ensure timely resolution and minimize delays.
- Communication: Communicate with insurance companies to clarify billing discrepancies and resolve issues, ensuring seamless claims processing.
- Payment Processing:
- Payment Posting: Post payments received from insurance companies and patients to the appropriate accounts, ensuring accurate and timely recording.
- Account Reconciliation: Reconcile accounts and ensure accurate recording of transactions, maintaining a high level of financial integrity.
- Invoice and Statement Preparation: Prepare and send patient invoices and statements, ensuring timely and accurate communication.
- Compliance and Documentation:
- Regulatory Compliance: Maintain compliance with healthcare regulations, including privacy and confidentiality standards, ensuring the highest level of patient data protection.
- Regulatory Updates: Stay up-to-date with changes in billing regulations and insurance policies, ensuring that our processes remain compliant and efficient.
- Documentation: Ensure accurate and complete documentation of billing activities, maintaining a clear and transparent record of all transactions.
- Reporting and Analysis:
- Reporting: Generate billing and financial reports for management review, providing valuable insights into our revenue cycle performance.
- Data Analysis: Analyze billing data to identify trends and areas for improvement, informing strategic decisions and process enhancements.
- Process Optimization: Provide recommendations for optimizing billing processes, ensuring that our operations remain efficient and effective.
- Diploma or certificate in medical billing, health administration, or a related field.
- Medical Terminology course preferred.
- Minimum of 2 years of experience in medical billing or a similar role in Ontario.
- Relevant healthcare and/or registration experience preferred.
- Knowledge of medical coding systems (ICD-10, CPT) and billing software.
- Familiarity with OHIP & WSIB billing procedures and guidelines.
- Strong attention to detail and accuracy.
- Excellent communication and interpersonal skills.
- Proficiency in Microsoft Office Suite and EHR systems.
- Experience in electronic medical records systems preferred.
- Ability to manage multiple tasks and meet deadlines.
- Competitive salary and benefits package.
- Opportunities for professional development and advancement.
- Collaborative and supportive work environment.
- Commitment to work-life balance.