[Hiring] Billing Specialist @U.S. Renal Care

Role Description

A Medical Billing Specialist translates healthcare services into financial claims, serving as an intermediary between our practices, patients, and insurance companies. They manage the revenue cycle by submitting claims, tracking payments, and resolving denials to ensure our providers are properly reimbursed.

• Claim Submission: Prepare and submit accurate claims to Medicare, Medicaid, and commercial payers using standardized medical codes (ICD-10, CPT).
• Denial Management: Investigate rejected or denied claims, correct discrepancies, and submit appeals to recover lost revenue.
• Payment Posting & Reconciliation: Post insurance and patient payments to EMR, and manage Accounts Receivable (AR) aging reports to identify and work outstanding balances.
• Compliance: Ensure billing practices adhere to HIPAA guidelines and federal healthcare laws.
• Contact Practice Managers, clinical or hospital personnel at the centers, Credentialing Specialist, and insurance companies to obtain missing and incorrect information.
• Patient Billing: Generate patient statements, handle billing inquiries.
• Maintain a professional working relationship with all the center and leadership staff.
• Performs other duties and responsibilities as required or assigned.

Qualifications

• Education: High school diploma or GED; specialized vocational training or an Associate Degree in Health Information Technology and Certified Professional Coder (CPC) is highly preferred.
• No less than five years of experience in health/medical billing.
• Technical Skills: Proficiency with Electronic Health Records (EHR) software, medical billing platforms, and Microsoft Office.
• Advanced knowledge of medical terminology as well as knowledge of government and private insurer rules and regulations.
• Advanced knowledge of CPT, ICD-10 and HCPCS coding, as well as in-depth knowledge of medical billing requirements.
• Strong competence in utilization of the Medicare, Medicaid websites and commercial insurance websites and portals to manage claims.
• Must be able to maintain confidentiality in regard to HIPAA rules and regulations, as well as private company matters.
• Soft Skills: Strong attention to detail, excellent problem-solving abilities, and customer service skills when discussing sensitive financial matters with patients, able to identify and solve patterns of ineffective claim processing, strong collaboration with Operations leadership to optimize the claim and collection processes.
• Ability to function well and maintain productivity in a home office environment.
• Must be flexible and available to attend meetings across multiple time zones, recognizing the variability in scheduling needs.