Billing Specialist II: Claims & Revenue Cycle Expert

Mednorth Health Center; Kirkland (NC); On-site; USD 42,000 - 60,000; Full time

Job summary

MedNorth Health Center in Wilmington, NC is seeking a Billing Specialist to manage inpatient and outpatient claims within the Revenue Cycle, including claim creation, submission, and follow-up with providers, payers, and patients.

The ideal candidate has a High School Diploma or GED with at least 3 years of billing experience, proficiency with ICD-10 and CPT/HCPCS, knowledge of EHR systems (Medent preferred), and strong communication and detail-oriented skills.

Qualifications

• High School Diploma/GED with minimum 3 years billing experience.
• Strong knowledge of ICD-10, CPT/HCPCS codes, medical terminology, and billing processes.
• Knowledge of Medical Billing/EHR systems, preferably Medent.
• Knowledge of EOBs, EFTs and ERAs.
• Knowledge of Microsoft Office software.
• Must be focused, self-directed, organized, and have demonstrated problem-solving abilities.
• Accurate and precise attention to detail.
• Excellent verbal and written communication skills.
• Able to work both independently and as part of a team.
• Must possess team leadership skills and have a positive disposition.

Responsibilities

• Prepares and submits clean claims to third party payers either electronically or by paper.
• Follows billing guidelines and legal requirements to ensure compliance with federal and state regulations.
• Respond to account inquiries from patients, payers, providers, and/or other staff as requested.
• Identifies and resolves patient/insurance billing issues.
• Work closely with team members regarding claim appeals, denials, resolution, and education.
• Performs and monitors all steps in the billing processes to ensure maximum reimbursement from patients, government, and commercial payers as well as from special billing arrangements.
• Understands Medicare, Medicaid and other commercial payer rules and regulations applicable to billing. Updates business office staff, clinics, residents, and faculty of changes as appropriate.
• Responsible for ensuring all new providers are oriented to coding, billing, and documentation compliance.
• Responsible for the continuing coding, billing, and documentation education for all providers and residents.
• Use online healthcare databases and other resources for verification and claim status.
• Deliver the highest quality service to internal and external customers.
• Assist other members of the team with projects as needed.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Other duties as assigned by management.
• Adhere to the Mission and Values of MNHC.

Skills

Billing experience

HIPAA compliance

Attention to detail

Communication skills

Team leadership

Microsoft Office

ICD-10 knowledge

CPT/HCPCS coding

Education

High School Diploma or GED

Certified Professional Coder (CPC) or equivalent

Tools

Medent (EHR)

Job description

MedNorth Health Center in Wilmington, NC is seeking a Billing Specialist to manage inpatient and outpatient claims within the Revenue Cycle, including claim creation, submission, and follow-up with providers, payers, and patients.

The ideal candidate has a High School Diploma or GED with at least 3 years of billing experience, proficiency with ICD-10 and CPT/HCPCS, knowledge of EHR systems (Medent preferred), and strong communication and detail-oriented skills.