Billing Specialist

KEY FUNCTIONS & RESPONSIBILITIES:

• Post and submit daily EOB’s from ALL Insurance carriers and other miscellaneous remittances which include (Care for Kids, Montgomery Cares, Commercial payors, Medicaid, Medicare, and Dental payors (commercial and managed care).
• Research forms documenting patient visit information and making corrections to the amount due from patient and insurance.
• Record amounts received and prepare transaction reports in the practice management system.
• Provide support to the clinics and attend outside meetings if necessary.
• Audit claims, accounts, payer, and vouchers, and prepares adjustments reports to substantiate individual transactions to resolve payment issues.
• Review, investigate, and correct errors and document inconsistencies in practice management system entries, documents, and reports.
• Notify the Manager of balances that need to be written off.
• Audit weekly reports for the corporate office which include: Daily Receipts, Copies of Reconciliation Envelope, Print –out of Charges and Receipts, and Original Encounters, and maintain accurate and complete files, ensuring that they are in compliance with CCI Policies and initialing for review completion.
• Working knowledge of HCPCS, CPT, ICD, and revenue codes using appropriate manuals and resources, both hard-copy and online to facilitate billing.
• Meets productivity goals as set by Management.
• Recognizes and performs essential duties and aids others or performs other required tasks, as assigned by management, when own assignments are completed.
• Coordinate communications with payers to ensure accurate billing practices, enhance reimbursement opportunities, achieve cash collections targets, and reduce or maintain A/R 0ver 120 days at and below the targets level.

OTHER SKILLS AND ABILITIES:

• A minimum of one (1) year of experience as a medical biller or coder, is preferred.
• Attention to detail and ability to work in a fast-paced environment
• Preferred experience/knowledge of FQHC billing guidelines and procedures
• Solid understanding of billing software and electronic medical records.
• Maintain up-to-date knowledge of insurance guidelines, Medicare, and state Medicaid
• Experience with and understanding of CPT, ICD-10 coding
• Must have the ability to multitask and manage time effectively.
• Excellent written and verbal communication skills.
• Outstanding problem-solving and organizational abilities.
• Excellent computer skills and interpersonal skills
• Knowledge of the full revenue cycle (processing claims, resolving denial, maximizing reimbursement, A/R)
• Knowledge of billing, reimbursement, and third-party regulations
• Experience with eCW, a plus
• Knowledge of healthcare governing agency policies and procedures
• Knowledge of medical terminology
• Must have good interpersonal/human relations skills
• Verbal and written communication skills
• Planning and organizational skills
• Ability to work independently and as part of a team
• Ability to work in a fast-paced environment
• Ability to interpret accounts and records, and develop spreadsheets and reports
• Ability to perform basic bookkeeping and compile statistics
• Ability to type, and operate a personal computer and various office equipment
• Ability to prepare reports, and maintain records and files
• Ability to extract data from conversations and documents
• Ability to maintain confidentiality - ensure the privacy and security of protected health information per HIPAA requirements.
• Exhibits and promotes a standard of excellence in the performance of all duties and interactions with patients, co-workers, and outside contacts.
• Working on-site is an essential duty for the job. 
• Perform other duties or special projects as assigned.

EDUCATION AND EXPERIENCE:

• H.S. Diploma or equivalent is required
• Medical Billing/Coder certification, a plus
• One (1) medical billing and coding experience, preferred
• Computer skills in Microsoft Office, excellent organizational, verbal, and written communication skill

CCI Health Services is a 49-year-old Federally Qualified Health Center is a diverse and inclusive workplace that serves 60,000 medical patients and Women Infant’s & Children (WIC) participants in Montgomery and Prince George’s Counties. As a 501(c)3 non-profit, CCI is committed to providing high-quality, affordable primary healthcare to every patient across all life stages. Visit www.cciweb.org for more information.