Medical Billing Specialist

The Medical Billing Specialist position is an essential support role within the Revenue Cycle Management (RCM) team responsible for verifying patient eligibility, claim edits, authorization edits, and medical records submissions. The Medical Billing Specialist acts as a consistent point of contact for both our patients and third-party billing vendor resolving billing issues on patient accounts. It is necessary that within this role, the Medical Billing Specialist cultivates and supports a strong team culture and collaborative environment centered on consistently delivering exceptional performance and outcomes.

Essential Responsibilities & Tasks

• Exhibit exceptional customer service skills; answering patient and insurance calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally.
• Provide support to front desk staff through solid relationships and communications.
• Verify all patient eligibility via electronic health record, Medicaid portal, insurance company websites, etc., to ensure claims are submitted to correct payer.
• Identify problems with patient eligibility/insurance coverage and correct as needed.
• Research accuracy of billing information and correct any errors or edits as needed.
• Send medical records for workers compensation and auto claims and ensure date of injury (DOI) is added prior to claim submission.
• Work closely with CCPSA’s 3rd party patient billing and collection vendor.
• Compile and enforce all policies and procedures related to the position, the department, and the company.
• Promote the CCPSA culture of team collaboration, while identifying and implementing opportunities to enhance the shared values of the group.
• Proactive resolution of issues and timely response to questions and concerns including clear, timely, and accurate documentation.
• Work with RCM team to aggregate and identify trends to analyze (trending analysis).
• Other duties as assigned by leadership.