Certified Professional Coder/Billing Specialist

Carson Medical Group; Nevada; Vor Ort; USD 24.000 - 34.000; Vollzeit

Benefits dieser Stelle

401(k)

401(k) matching

Dental insurance

Employee assistance program

Flexible schedule

Flexible spending account

Health insurance

Paid time off

Tuition reimbursement

Vision insurance

Zusammenfassung

Carson Medical Group in Carson City, NV seeks a Billing Specialist to maximize revenue by ensuring timely reimbursement and to support patients with claim-related questions. You will liaise with addresses, payers, and CMG staff to maintain efficient billing operations.

Applicants should have high school diploma, billing experience, and CPC certification or in progress, with strong communication and computer skills.

Qualifikationen

• Medical billing experience preferred.
• Strong communication and written skills.
• Familiarity with CPT/HCPCS/ ICD-10 and revenue cycle.
• Ability to maintain HIPAA confidentiality.

Aufgaben

• Submit claims promptly and accurately.
• Follow up on unpaid or aged accounts.
• Resolve denied/errored claims with proactive outreach.
• Document interactions per CMG policies.

Kenntnisse

Customer service

Communication

Medical billing

Ausbildung

High School Diploma or Equivalent

Certified Professional Coder (CPC)

Tools

Outlook

EMR software

Jobbeschreibung

JOB SUMMARY

The Billing Specialist is responsible for maximizing revenue by ensuring timely and accurate reimbursement from insurance companies and third-party administrators for services provided. Key responsibilities include submitting claims promptly, proactively following up on unpaid or aged accounts, and resolving denied or errored claims through consistent and thorough efforts. In addition, the Billing Specialist supports patients by answering claim-related questions and coordinating benefits among multiple payers. Serving as a liaison between patients and their insurance carriers, this role requires a commitment to delivering exceptional customer service to all Carson Medical Group (CMG) customers. The Billing Specialist collaborates closely with Patient Service Representatives, Cashiers, Account Representatives, and the Billing Manager to promote efficient and accurate billing operations.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

• Utilizes the _C.L.E.A.R_. and _H.E.A.R.T_. methods of providing excellent customer service throughout every patient/customer interaction.
• Consistently utilizes an articulate, pleasant, and animated voice during all patient/customer interactions.
• Utilize a basic understanding of CMG, the providers, locations, and general organization information to answer basic inquiries and questions. If unable to answer a specific question, locate the answer on behalf of the caller or direct the caller to an individual who is able to assist.
• Utilize a thorough understanding of CMG's revenue cycle to ensure appropriate handling of business and billing inquiries.
• Appropriately utilize Workflow Queue Dashboard as outlined in the _Billing Policy and Procedure_.
• Works with patients to resolve complaints utilizing the _H.E.A.R.T_ model, answer questions, and help facilitate coordination of benefits (COB) issues to ensure proper payment of outstanding claims.
• Handles each claim appropriately in adherence to CMG's _Billing Policy and Procedure_.
• Write clear, concise appeals for denied claims in a timely manner in adherent to CMG's _Appeal/Redetermination Policy and Procedure_.
• Quickly rectify error(s) and submit corrected claims for claim denials due to error in claim submission.
• Identifies trends with payers or inefficient claim scrubbing and promptly and effectively communicates this to the Business Office Manager.
• Process all overpayments (payer and patient) in adherence with CMG's _Refund Policy and Procedure_.
• Prompt and accurate response to insurance correspondence.
• Accurately documents interactions and steps taken in adherence with CMG's _Business Office Documentation & Correspondence Policy and Procedure_.
• Maintain strict confidentiality in compliance with HIPAA.
• Performs all other duties as assigned.

EDUCATION AND EXPERIENCE REQUIREMENTS

Education: High School Diploma or Equivalent

Certification/License: Certified Professional Coder or required, or in process of obtaining

Physical Requirements (physical abilities essential to perform the job): Ability to sit at a computer for an extended period of time.

Experience: Medical billing experience preferred. Ability to communicate effectively, both written and verbal communication, with persons of various cultural and educational backgrounds. Competency with basic computer skills, Outlook, and ability to learn and navigate EMR software. Full command (verbal and written) of the English language. Intimate understanding of the revenue cycle of medical practices. CPT, HCPCS, and ICD-10 proficient. Basic math skills. The physical ability and perceptive acuity to satisfactorily perform all essential job functions. OR any combination of education, professional training or work experience, which demonstrates the ability to perform the duties required for the position.

Job Type & Pay

• Job Type: Full-time
• Pay: From $21.25 per hour
• Expected hours: 40.0 per week

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Experience & Location

• Experience: Medical billing:2 years (Required)
• Ability to Commute: Carson City, NV 89706 (Required)
• Ability to Relocate: Carson City, NV 89706:Relocate before starting work (Required)
• Work Location: In person.