Billing Specialist

Description

 CPIhealth is a multidisciplinary team dedicated to providing compassionate and comprehensive care to individuals experiencing chronic pain. With state-of-the-art facilities, advanced technology, and a collaborative environment, we offer a platform for healthcare providers to excel in their specialties while making a profound difference in the lives of those we serve. 

As you consider your next career move, we invite you to join us in redefining pain management through innovation, expertise, and a commitment to improving patient outcomes. Together, we can shape the future of healthcare and positively impact countless lives.

The Billing Specialist is responsible for investigating and implementing measures to research unpaid claims from insurance companies. Files third-party claims with insurer and monitors a claim until it has been settled. Works directly with patients to insure accounts are paid in a timely manner utilizing EMR software.

Essential Functions: 

• Researches and records complete and accurate patient service data and uses this data in the filing of insurance claims.
• Researches edit lists, correcting errors and making sure that claim corrections are submitted appropriately and timely.
• Researches, corrects and resubmits rejected claims.
• Works each task to completion each month.
• Files supplementary insurance claims as needed.
• Monitors status of insurance billings for accurate and timely collection of accounts and reviews posted payments and adjustments for accuracy.
• Reviews payments and adjustments to insure accounts are posted correctly.
• Send adjustment requests to insurer if only partial payment is received.
• Works and monitors every account assigned to them.
• Requests refunds on accounts where overpayment exists.
• Processes credit card payments when needed.
• Ensures collection laws are followed.
• Responds to patient billing questions.
• Advises clinic personnel of insurance coverage criteria in order to secure payment
• Acts as a resource for providers and staff in payer/reimbursement issues.
• Identifies reimbursement issues and trends and keeps Manager appraised.
• Provides services to patients, staff, and others in a respectful and courteous manner. 
• Works collaboratively with appropriate staff to ensure effective and efficient services.
• Maintains confidentiality when necessary and employs discretion when involved with sensitive matters. 
• Exercises prudent stewardship of financial and other resources.

Requirements

• High School Diploma or equivalent
• 1-2 years of experience in clinical charge entry. 
• Understands medical terminology, billing software and electronic medical records.
• Excellent communication skills, both written and verbal.
• Proficient with computer applications and software to include Microsoft Office Suite
• Ability to demonstrate knowledge in working CPT4 and ICD10 codes and understand governmental coding and billing regulations.
• Exhibits a high level of problem-solving skills and is highly motivated, trustworthy, and can work independently.