CTHCA Certified Billing Specialist (TM-49442)
About The Position
The Certified Billing Specialist is responsible for the accurate and timely preparation and submission of medical claims to third-party payers. This position performs advanced medical billing and accounts receivable functions, resolves claim denials, and ensures accurate insurance verification and reimbursement. The Certified Billing Specialist communicates professionally with providers, payers, and internal team members to address insurance and billing inquiries while maintaining strict confidentiality. All duties are performed with professionalism, accuracy, and integrity, ensuring that the needs of team members and organizational operations are met with a pleasant, service-oriented demeanor and in accordance with organizational values, policies, and regulatory requirements.
Requirements
- Associate’s degree and completion of a Medical Billing and Coding program of one year or longer (transcript required), OR Two (2) years of medical billing experience involving Medicare, Medicaid, and third-party payers within FQHC, IHS, or Tribal health programs.
- Certification from a nationally recognized organization such as HFMA, AAHAM, or AAPC, with certification maintained throughout employment.
- HIPAA certification required within the first ninety (90) days of employment.
- Ability to understand, speak, read, and write the English language clearly and professionally.
- Working knowledge of medical billing practices, terminology, and accounts receivable processes.
- Working knowledge of medical billing code sets including ICD-10, CPT, and HCPCS.
- Knowledge of Medicare, Medicaid, and third-party billing regulations, policies, procedures, and modifier usage.
- Proficiency in Microsoft Word, Excel, Outlook, and PowerPoint, as well as electronic health records (EHR) and revenue cycle management systems.
- Strong mathematical skills sufficient to calculate sums, percentages, ratios, and reconcile account balances.
- Ability to analyze data from multiple sources to identify trends, discrepancies, and solutions.
- Ability to plan, organize, prioritize, and manage workload in a high-volume, deadline-driven environment.
- Ability to communicate technical and financial information effectively to diverse audiences both verbally and in writing.
- Well-developed human relations skills to interact cooperatively, professionally, and courteously with patients, coworkers, leadership, and external partners.
- Ability to handle sensitive information with discretion and maintain strict confidentiality.
- Ability to work independently while following established policies, procedures, and guidelines.
- Ability to take initiative, be proactive, and follow tasks through to completion to meet goals and mandated deadlines.
- Ability to work collaboratively as a contributing member of a team and convey a positive image of the organization and its services.
- Possess and maintain a valid Washington State driver’s license and be eligible for the Tribes’ Vehicle Insurance (if required).
Responsibilities
- Accurate and timely preparation and submission of medical claims to third-party payers.
- Perform advanced medical billing and accounts receivable functions.
- Resolve claim denials.
- Ensure accurate insurance verification and reimbursement.
- Communicate professionally with providers, payers, and internal team members to address insurance and billing inquiries.
- Maintain strict confidentiality.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
