The precise billing of healthcare providers’ services to patients and third-party payers (such insurance companies) is the responsibility of Medical Billing Specialists. For services to be accurately documented and paid for compensation, they must negotiate a labyrinth of rules, regulations, and patient records.

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Job Duties in Medical Billing:

Maintains correct and up-to-date provider records
Monitors applications and follows up as necessary; completes provider credentialing and re-credentialing processes.
Keeps on file the necessary credentialing documentation for all providers, including up-to-date state licenses, DEA certifications, malpractice insurance, and more.
Keeps records of contracts with corporate providers
Keeps up-to-date on the credentialing requirements of health plans and agencies
Makes ensuring that all providers’ licenses and certifications are renewed on time by keeping track of when they expire.
Keeps health plans, agencies, and other parties up-to-date on practice addresses
Verifies the accuracy and currency of provider data stored in health plan directories.
Integrating EHR systems (e.g., Care Cloud, Office Ally) with a new provider
Managing the enrollment process for both new and existing providers, including EDI, ERA, and EFT.
Developing and overseeing online portals for all stakeholders