[Hiring] Billing Specialist @Vivent Health

Role Description

The Billing Specialist plays an integral role in our growing Healthcare Revenue team. This person is goal-oriented, compliant, revenue-driven, highly organized/accurate, and motivated. This person is focused on all areas of the revenue cycle for specific Vivent Health Clinics and Departments.

• Deliver Excellence. Oversee with Integrity. Drive Progress. Exceed Expectations.

Essential Job Duties:

• Review medical records and assign appropriate diagnosis and procedure codes based on guidelines.
• Efficient and timely Revenue Cycle work within EPIC including: Charge Review, Claim Edit, Payment Posting, AR Follow-up, Refunds, Patient Support, and Billing Performance vs. Budget.
• Work closely with the Clinic Department Manager, Health Services Administrator, Patient Services Representatives, Coders, EPIC Site Specialist, and Vendors to ensure the entire Revenue Cycle is managed well.
• Monitor and follow up on outstanding claims, denials, and appeals to resolve billing discrepancies and ensure maximum reimbursement.
• Prepare and maintain billing reports, metrics, and documentation to track billing activities, revenue trends, and collections performance.
• Meet and exceed patient satisfaction expectations and goals aligned with Vivent Health mission.
• Assist with payment posting, credentialing projects, fee schedule analysis, and additional projects that support the Healthcare revenue cycle department.
• Other duties as assigned.
• Adhere to all agency policies, including but not limited to Confidentiality, Employee Handbook, Health Care Corporate Compliance Plan, Standards of Conduct, training, and other relevant policies.

Qualifications

• High school diploma or equivalent; Associates degree preferred.
• Minimum of 2-3 years of experience in medical billing or healthcare revenue cycle management, preferably in a clinic or healthcare setting.
• Proficiency in EPIC Resolute Billing.
• Excellent experience with Microsoft Office applications.
• Experience with CPT and ICD-10 coding; familiarity with medical terminology.
• Experience in filing claim appeals with insurance companies to ensure compliant, maximum reimbursement.
• Excellent customer service skills.
• Strong written and verbal communication skills.
• Meticulous attention to detail in reviewing billing codes, claims, and payments to ensure accuracy and compliance.
• Strong analytical skills to identify trends and address billing issues effectively.
• Ability to manage relationships with various Insurance payers, including Credentialing Managers and Regional payer representatives.
• Understanding of HIPAA compliance and responsible use of confidential information.
• Ability to handle multiple projects and work courteously and respectfully with fellow employees, clients, and patients.
• Effective problem-solving skills and can-do attitude to resolve billing discrepancies, denials, and appeals in a timely manner.
• Commitment to staying updated on industry trends, regulations, and best practices in medical billing and revenue cycle management.

Requirements

• HIV experience in a not-for-profit environment (preferred).

Benefits

• Generous paid time off, including 12 paid holidays.
• 401k with 100% employer match up to 5%.
• 12 weeks of fully paid parental leave.
• Employer subsidized medical, dental, vision benefits, and gender-affirming care benefits.
• Employer paid short and long-term disability.
• Tuition reimbursement, certification, and licensure assistance.
• Benefits for part-time roles.

Company Description

Vivent Health is dedicated to fostering a workforce that reflects diverse backgrounds, perspectives, and experiences, enabling you to have a meaningful impact in our communities and the lives of the amazing patients we serve.

• Equity Practices: Fair treatment, access, and opportunities for all employees.
• Professional Growth: Opportunities for professional development and advancement.
• Collaboration on an inter-disciplinary team: Exposure to whole person-care across medical, behavioral health, pharmaceutical, research, and more.
• Delivery of quality patient care: Proven integrated HIV care and prevention model.