FIN - Billing Specialist I

Community Clinic Inc.•Silver Spring, MD

13h

About The Position

CCI Health Services’ mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone. Position Summary The Billing Specialist will perform a range of responsibilities requiring data analysis, critical evaluation, and sound judgment, including maintaining billing software, appealing denied claims, and recording late payments.

Requirements

Strong attention to detail with the ability to thrive in a fast-paced environment.
Solid understanding of billing software and electronic medical record (EMR) systems.
Maintain current knowledge of insurance guidelines, including Medicare and state Medicaid programs.
Proficient in CPT and ICD-10 coding.
Strong multitasking abilities and effective time management skills.
Excellent written and verbal communication skills.
Outstanding problem-solving and organizational abilities.
Advanced computer literacy and strong interpersonal skills.
Thorough understanding of the full revenue cycle, including processing claims, resolving denials, maximizing reimbursement, and managing accounts receivable (A/R).
Knowledge of billing, reimbursement procedures, and third-party regulations.
Familiarity with healthcare governing agency policies and procedures.
Knowledge of medical terminology.
Strong interpersonal and human relations skills.
Ability to work independently as well as collaboratively within a team.
Comfortable working in a fast-paced environment.
Skilled in interpreting accounts and records, developing spreadsheets, and generating reports.
Capable of performing basic bookkeeping and compiling statistical data.
Proficient in operating a personal computer and various office equipment.
Ability to prepare reports and maintain organized records and files.
Skilled in extracting relevant data from conversations and documents.
Committed to maintaining confidentiality and ensuring the privacy and security of protected health information in compliance with HIPAA requirements.
Demonstrates and promotes a standard of excellence in all duties and interactions with patients, colleagues, and external contacts.

Nice To Haves

Certified Coder and/or Revenue Cycle Specialist preferred.
Minimum of two (2) years of experience as a medical biller or coder preferred.
Experience and/or knowledge of FQHC billing guidelines and procedures preferred.
Experience with eClinicalWorks (eCW) is a plus.

Responsibilities

Review and research forms documenting patient visit information, making corrections to amounts due from patients and insurance as needed.
Contact insurance companies to verify patient coverage, determine schedules of payors, and obtain detailed information regarding benefits. Compute total bills showing amounts to be paid by both insurance and patients.
Examine patient bills for accuracy and completeness, obtaining any missing information to ensure proper billing.
Prepare, review, and transmit claims using billing software, including both electronic and paper claim processing.
Follow up on unpaid claims within standard billing cycle timeframes.
Respond to all patient and insurance inquiries related to assigned accounts in a timely and professional manner.
Audit claims, accounts, payers, and vouchers; prepare adjustment reports to substantiate individual transactions and resolve payment issues.
Provide support to clinics and attend external meetings as required.
Review, investigate, and correct errors, documenting inconsistencies in practice management system entries, documents, and reports.
Maintain working knowledge of HCPCS, CPT, ICD, and revenue codes using appropriate manuals and resources (both hard-copy and online) to facilitate accurate billing.
Achieve productivity goals as established by management.
Perform essential duties, assist colleagues, and complete other tasks assigned by management upon finishing own assignments.
Coordinate communications with payers to ensure accurate billing practices, enhance reimbursement opportunities, achieve cash collection targets, and maintain accounts receivable (A/R) over 120 days at or below target levels.
Perform other duties or special projects as assigned.