Experienced Healthcare Billing Specialist - Revenue Cycle Management & Quality Assurance Expert

Transform Your Career with a Leading Healthcare Billing Services Provider

Join our dynamic team as a Healthcare Billing Specialist and become an integral part of our mission to deliver top-notch billing services to medical practices across San Diego County. As a key member of our remote team, you'll leverage your expertise in medical billing, quality assurance, and revenue cycle management to drive success and grow professionally in a collaborative environment.

About Our Company

We're a pioneering healthcare billing services provider dedicated to innovation, continuous improvement, and excellence. Our team is passionate about delivering exceptional service to our clients, and we're seeking a talented Healthcare Billing Specialist to help us achieve our goals. As a remote team member, you'll enjoy the flexibility and autonomy to work from anywhere while being part of a close-knit team that's committed to making a difference in the healthcare industry.

Key Responsibilities

• Billing and Claims:
  • Prepare, review, and transmit clean claims to third-party payers (both electronically and by paper).
  • Request prior authorizations for services and ensure compliance with insurance guidelines.
  • Address rejected claims efficiently and effectively, and maintain a strong relationship with our clearinghouse.
  • Check eligibility and benefits utilizing third-party sources, and research denied claims to execute the appeals process.
  • Manage the monthly statement process, ensure accuracy of payment, and post payments to respective accounts.
  • Demonstrate expertise in CPT and ICD-10 coding, and follow up on unpaid claims within the standard billing cycle timeframe.
• Customer Service:
  • Provide excellent customer service through patient education, listening, and effective communication.
• Compliance and Quality Assurance:
  • Adhere to HIPAA guidelines, policies, and procedures, and demonstrate an understanding of objectives and key results related to medical billing.
  • Prepare key performance indicators reports for the Billing Department, and conduct quality assurance audits to ensure high standards.
  • Develop processes to improve efficiencies and quality within the Billing Department, and contribute to the team's continuous improvement efforts.

Essential Qualifications

To succeed in this role, you'll need:

• A minimum of 5 years of experience in a medical office setting, with at least 3 years of experience in healthcare billing and quality assurance.
• 2+ years of experience in revenue cycle management, with a proven track record of success.
• A strong understanding of medical billing processes, insurance guidelines, and regulatory requirements.
• Expertise in CPT and ICD-10 coding, with the ability to stay up-to-date with changing regulations and guidelines.
• Excellent analytical, problem-solving, and communication skills, with the ability to work effectively in a team environment.

Preferred Qualifications

While not essential, the following qualifications are highly desirable:

• A Bachelor's degree in a related field, such as healthcare administration or business.
• Certifications in medical billing, such as CPC or CMM.
• Experience with electronic health records (EHRs) and practice management systems (PMS).

Skills and Competencies

To excel in this role, you'll need:

• Strong analytical and problem-solving skills, with the ability to analyze data and identify trends.
• Excellent communication and interpersonal skills, with the ability to work effectively with patients, providers, and payers.
• A high level of attention to detail, with the ability to maintain accuracy and quality in a fast-paced environment.
• Proficiency in Microsoft Office and other software applications, with the ability to learn new systems and technologies.
• A commitment to ongoing learning and professional development, with a passion for staying up-to-date with industry trends and best practices.

Career Growth Opportunities and Learning Benefits

As a member of our team, you'll have access to:

• Ongoing training and professional development opportunities, designed to help you stay current with industry trends and best practices.
• A collaborative and supportive work environment, where you'll be encouraged to share your ideas and expertise.
• Opportunities for career advancement, as we continue to grow and expand our services.

Work Environment and Company Culture

We're a remote team that values flexibility, autonomy, and work-life balance. As a Healthcare Billing Specialist, you'll enjoy:

• The ability to work from anywhere, at a time that suits you.
• A collaborative and supportive team environment, where you'll be connected with colleagues and leaders through regular virtual meetings and communication channels.
• A culture that prioritizes ongoing learning and professional development, with opportunities to grow and advance in your career.

Compensation and Benefits

We offer a competitive salary range of $20-$28 per hour, depending on experience, as well as a comprehensive benefits package that includes:

• 401(k) plan
• Dental, health, and vision insurance
• Life insurance

Schedule and Work Arrangement

This is a full-time role, with expected hours of 40 per week, Monday to Friday. We're a remote team, so you'll have the flexibility to work from anywhere.

Join Our Team!

If you're a motivated and experienced Healthcare Billing Specialist looking for a new challenge, we want to hear from you! Don't worry if you don't meet every single requirement - we value a great attitude and a willingness to learn above all. Submit your application today and take the first step towards a rewarding career with our team.