Billing Specialist

Community Clinic Inc. • Silver Spring, MD

28d • $25 - $30

About The Position

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

• Minimum of a high school diploma required; Associate’s (AA) or Bachelor’s (BS) degree preferred, or equivalent experience.
• Minimum of two (2) years of experience as a medical biller or coder required.
• Proficient in Microsoft Office; strong organizational, verbal, and written communication skills.
• 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

• Medical Billing/Coding certification is a plus.
• 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.

Benefits

• Extensive benefits plan including PTO
• 403B Retirement Plan
• Tuition reimbursement opportunities
• Continuing education assistance; can be used toward obtaining certifications, renewal of certifications, or possible conference attendance.
• Our providers are insured for malpractice under FTCA.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree