Strategic Healthcare Billing & Claims Specialist

Cape Cod Healthcare; Hyannis (MA); On-site; USD 42,000 - 64,000; Full time

Job summary

Cape Cod Healthcare, Inc. is seeking a Billing Specialist to ensure accurate, timely submission of HIPAA-compliant claims to third-party payers.

You will verify information, review documentation, and collaborate across departments to resolve discrepancies in a fast-paced revenue cycle environment. The role requires at least 1 year of professional medical billing experience, familiarity with CPT/HCPCS/ICD-10-CM coding, and strong proficiency in Excel, Word, and Outlook.

Qualifications

• Must read, write, and communicate in English.
• High School diploma or GED required.
• Minimum 1 year of professional medical billing experience including EDI and payer portals.
• Knowledge of CPT/HCPCS/ICD-10-CM coding and modifiers.
• HIPAA regulations knowledge and proficiency with Excel/Word/Outlook.

Responsibilities

• Prepare and submit HIPAA compliant claims to third-party payers via EDI, clearinghouses, and payer platforms.
• Review documentation to ensure claim accuracy and payer guideline compliance prior to submission.
• Analyze edits and payer rejections; research, correct, and resubmit claims promptly.
• Collaborate with clinical and admin staff to resolve billing discrepancies and enable accurate submissions.
• Maintain knowledge of CPT/HCPCS/ICD-10-CM coding and modifiers for payers.

Skills

English proficiency

Analytical skills

Organizational skills

Problem solving

Education

High School diploma or GED

AA/BA in Business or Healthcare Admin preferred

Tools

Epic or comparable billing software

Job description

Cape Cod Healthcare, Inc. is seeking a Billing Specialist to ensure accurate, timely submission of HIPAA-compliant claims to third-party payers.

You will verify information, review documentation, and collaborate across departments to resolve discrepancies in a fast-paced revenue cycle environment. The role requires at least 1 year of professional medical billing experience, familiarity with CPT/HCPCS/ICD-10-CM coding, and strong proficiency in Excel, Word, and Outlook.