Position Overview: The Certified Billing Expert will be responsible for managing all aspects of the billing process, ensuring accuracy, compliance, and efficiency in revenue cycle management. The successful candidate will possess extensive knowledge of medical billing procedures, coding systems, insurance regulations, and reimbursement methodologies. They will play a critical role in maximizing revenue and minimizing denials through effective billing practices and proactive resolution of billing-related issues.
Responsibilities:
- Perform billing activities for medical services rendered, including charge entry, claim submission, payment posting, and accounts receivable management.
- Review and verify accuracy of patient demographic and insurance information to facilitate timely and accurate billing.
- Generate and submit claims to insurance carriers, government agencies, and other third-party payers in accordance with billing guidelines and regulations.
- Conduct thorough review of medical documentation to ensure appropriate coding and billing practices in compliance with industry standards and regulatory requirements (e.g., ICD-10, CPT, HCPCS).
- Monitor claim status, follow up on unpaid claims, and resolve billing discrepancies and denials in a timely manner.
- Communicate with insurance companies, patients, and healthcare providers to address billing inquiries, resolve disputes, and facilitate claims processing.
- Stay updated on changes in healthcare regulations, payer policies, and coding guidelines to ensure compliance and optimize reimbursement.
- Collaborate with internal departments, including finance, revenue cycle, and clinical teams, to streamline billing processes and improve revenue cycle performance.
- Prepare and analyze billing reports, metrics, and key performance indicators (KPIs) to identify trends, track performance, and recommend process improvements.
Qualifications:
- Bachelor's degree in healthcare administration, business, or related field preferred.
- Certified Professional Coder (CPC) certification or equivalent required.
- Minimum of 2 years of experience in medical billing and revenue cycle management.
- Proficiency in medical billing software and electronic health records (EHR) systems.
- Strong understanding of healthcare billing regulations, compliance requirements, and reimbursement methodologies.
- Excellent analytical skills and attention to detail.
- Effective communication and interpersonal skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Commitment to maintaining confidentiality and integrity of patient information.
- Strong problem-solving and decision-making abilities.
Job Type: Full-time
Pay: $19.11 - $23.01 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Work Location: In person