The Medical Billing Specialist prepares services rendered by clinic providers for billing to multiple entities via electronic or hardcopy claim. Medical Billing Specialist reviews and resolves current day electronic rejected/invalid submissions for correction.

Knowledge, Skills and Abilities:

  • Knowledge of ICD-9, HCPCS and CPT coding systems.
  • Knowledge of health insurance programs, coverage offered and third party reimbursement mechanisms, including Medical Software System, Medicare and Medicaid
  • Knowledge of an electronic medical record system; when applicable
  • Knowledge of manual and electronic billing procedures
  • Knowledge of all health care services offered at each clinic site
  • Knowledge of automated billing systems
  • Skill in communicating effectively to peers, supervisors and patients and to handle stressful situations appropriately
  • Skill in operating personal computer utilizing word processing, spreadsheets, databases, email and other office equipment
  • Maintains accurate and timely billing
  • Audits insurance information for appropriateness in current billing system
  • Ability to prioritize work
  • Ability to communicate both verbally and written
  • Ability to maintain confidentiality of information, most importantly patient financial and medical information
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
  • Follows timely filing guidelines per payer to ensure maximum payment.
  • Ability to understand and respond appropriately, effectively and sensitively to special population groups as defined by race, ethnicity, language, age, sex, etc.

  • Ability to hear and speak well enough to converse over telephone
  • Ability to see well enough to use computer efficiently and read computer reports and correspondence
  • Ability to lift up to 20 pounds on a frequent basis
  • Reasonable accommodation will be made for physical limitations on an individual basis
  • Willingness to learn, understand and abide by Community Health Alliance policies and procedures

Education and Experience:
High school diploma or general education degree (GED) required, certified coder (CPC) preferred. A minimum of two years medical billing experience preferred, or an equivalent thereof.

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