Certified Professional Coder/Billing Specialist

JOB SUMMARY:
The Billing Specialist is responsible for generating revenue by collecting monies due on accounts by obtaining prompt payment from insurance companies and/or third-party administrators for services rendered. This is done by timely claim submission to payers, diligent review of unpaid aged claims and aggressive efforts on denied/errored claims. The Billing Specialist is also responsible for assisting patients with claim questions and coordination of benefits with all involved payers. The Billing Specialists can act as a liaison between our patients and their insurance carriers, while providing exceptional customer service to all customers of Carson Medical Group (CMG). The Billing Specialist works closely with the Patient Service
Representatives, Cashiers, Account Representatives, and Manager to ensure accuracy and efficiency of billing practices.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:
1. Utilizes the C.L.E.A.R. and H.E.A.R.T. methods of providing excellent customer service throughout every patient/customer interaction.

2. Consistently utilizes an articulate, pleasant, and animated voice during all patient/customer interactions.

3. Utilize a basic understanding of CMG, the providers, locations, and general organization information to answer basic inquires and questions. If unable to answer a specific question, locate the answer on behalf of the caller or direct the caller to an individual who is able to assist.

4. Utilize a thorough understanding of CMG’s revenue cycle to ensure appropriate handling of business and billing inquiries.

5. Appropriately utilize Workflow Queue Dashboard as outlined in the Billing Policy and Procedure.

6. Works with patients to resolve complaints utilizing the H.E.A.R.T model, answer questions, and help facilitate coordination of benefits (COB) issues to ensure proper payment of outstanding claims.

7. Handles each claim appropriately in adherence to CMG’s Billing Policy and Procedure.

8. Write clear, concise appeals for denied claims in a timely manner in adherent to CMG’s Appeal/Redetermination Policy and Procedure.

9. Quickly rectify error(s) and submit corrected claims for claim denials due to error in claim submission.

10. Identifies trends with payers or inefficient claim scrubbing and promptly and effectively communicates this to the Business Office Manager.

11. Process all overpayments (payer and patient) in adherence with CMG’s Refund Policy and Procedure.

12. Prompt and accurate response to insurance correspondence.

13. Accurately documents interactions and steps taken in adherence with CMG’s Business Office Documentation & Correspondence Policy and Procedure.

14. Maintain strict confidentiality in compliance with HIPAA

15. Performs all other duties as assigned.

EDUCATION AND EXPERIENCE REQUIREMENTS:
Education: High School Diploma or Equivalent
Certification/License: Certified Professional Coder required
Physical Requirements (physical abilities essential to perform the job):
Ability to sit at a computer for an extended period of time.
Experience: Medical billing experience preferred

Ability to communicate effectively, both written and verbal communication, with persons of various cultural and educational backgrounds. Competency with basic computer skills, Outlook, and ability to learn and navigate EMR software. Full command (verbal and written) of the English language. Intimate understanding of the revenue cycle of medical practices. CPT, HCPCS, and ICD-10 proficient. Basic math skills. The physical ability and perceptive acuity to satisfactorily perform all essential job functions.

OR
Any combination of education, professional training or work experience, which demonstrates the ability to perform the duties required for the position.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• ICD-10 or CPT: 1 year (Required)

Work Location: Hybrid remote in Carson City, NV 89706