Certified Professional Coder/Billing Specialist

JOB SUMMARY:
The Billing Specialist is responsible for maximizing revenue by ensuring timely and accurate reimbursement from insurance companies and third-party administrators for services provided. Key responsibilities include submitting claims promptly, proactively following up on unpaid or aged accounts, and resolving denied or errored claims through consistent and thorough efforts.

In addition, the Billing Specialist supports patients by answering claim-related questions and coordinating benefits among multiple payers. Serving as a liaison between patients and their insurance carriers, this role requires a commitment to delivering exceptional customer service to all Carson Medical Group (CMG) customers.

The Billing Specialist collaborates closely with Patient Service Representatives, Cashiers, Account Representatives, and the Billing Manager to promote efficient and accurate billing operations.

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 or required, or in process of obtaining
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

Pay: From $21.25 per hour

Expected hours: 40.0 per week

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

Experience:

• Medical billing: 2 years (Required)

Ability to Commute:

• Carson City, NV 89706 (Required)

Ability to Relocate:

• Carson City, NV 89706: Relocate before starting work (Required)

Work Location: In person