Medical Billing Specialist


ABOUT THE POSITION

This position is part of the revenue cycle team. This position is responsible for entering data necessary for the collection of revenues from third party payers, as well as individual patients. This position may be the first interaction that patients have with Community Health and practices should not create barriers to obtaining care or information. This position requires significant time interacting with patients, payers, public on the phone, as such, excellent communication skills are required.

ESSENTIAL DUTIES

  • Review data entered into the Electronic Health Record for accuracy and completeness.
  • Verify/input diagnosis/procedure codes necessary for accurate billing of all charges for services.
  • Prepare and submit billing data and medical claims to insurance companies for reimbursement.
  • Knowledge of billing requirements for all payers and Federally Qualified Health Center guidelines for Medicare and Medicaid.
  • Timely A/R follow up on denied claims with an effort to ensure reimbursement.
  • Review of patient/insurance credits and processing of refunds.
  • Ability to respectfully communicate accurate information to patients regarding outstanding balance both on the phone and in person.
  • Assist with patient payment plans and posting of payments and adjustments.
  • Knowledge of financial assistance and sliding fee scales for all specialties.
  • Prepare invoices required for special programs reimbursed under separate contracts with CHCSEK.
  • Knowledge of primary code classifications: ICD-10-CM, CPT, CDT, HCPCS
  • Build and maintain positive, supportive working relationships with clients, patients, providers, community organizations, and others.
  • Perform other duties as assigned.

QUALIFICATIONS

  • High school diploma or equivalent required.
  • CPB (Certified Professional Biller), or willingness to become one within 6 months after date of hire.
  • Minimum of one year of experience working in a healthcare related field.
  • Any combination of education and work experience that would likely provide the required knowledge and abilities is qualifying.