Billing Specialist (Centrum Health)
Our mission is to make healthcare right. Together. We are a value-driven healthcare company committed to providing personalized care to aging and underserved populations. We do this by aligning stakeholders across the healthcare ecosystem. Together, we can improve consumer experience, optimize clinical outcomes, and reduce total cost of care.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The Biller Specialist is responsible for the accuracy of the super bill/claim prior to transmission to payer, including validation of appropriate Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). This is not a remote position and will require associate to commute to Centrum Medical Corporate Office.
- Assign/remove CPT, HCPCS and modifiers as part of the super bill/claim validation process.
- Prepare and review super bill/claims prior to submission.
- Identify coding trends and opportunities to improve quality, efficiency and productivity
- Checking each insurance payment for accuracy.
- Ensure compliance with billing and payers guidelines
- Calling insurance companies regarding any discrepancy in payments if necessary
- Researching and appealing denied claims.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- High school diploma or GED equivalent
- Minimum of 1 year of experience as a medical biller.
- Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
- Knowledge on CPT, ICD-10-CM and HCPCS codes.
- Knowledge of coding principles and guidelines.
- Knowledge of billing principles and guidelines.
- Knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
- Excellent written and oral communication skills
- Fluent in English and Spanish
LICENSURES AND CERTIFICATIONS
- Prefer but not require American Academy of Professional Coder (AAPC) Certified Professional Coder (CPC) or American Health Information Management Association (AHIMA) Certified Coding Specialist (CCS).
- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
- Travel may be required.
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