Medical Billing Specialist

Position Summary:

Critical Care, Pulmonary and Sleep Associates is a multispecialty private physician practice, providing Critical Care, Pulmonary and Sleep medical services to the Denver metro area for over 40 years. Our dedicated team of over 35 Board Certified Critical Care, Pulmonary and Sleep Physicians along with our skilled clinical and administrative staff exclusively serve nine Common Spirit and AdventHealth Hospital ICU’s and multiple outpatient clinic locations spanning Colorado’s front range. CCPSA’s organizational culture exemplifies excellence in patient centered care, unified teamwork, and a highly collaborative approach in all business and clinical operations.  We are currently seeking a Billing Payment Specialist to join our committed team of professionals.

The Billing Payment Specialist position is an essential support role within the Revenue Cycle Management (RCM) team responsible for verifying patient eligibility, claim edits, authorization edits, and medical records submissions. The Billing Payment Specialist acts as a consistent point of contact for both our patients and third-party billing vendor resolving billing issues on patient accounts. The Billing Payment Specialist cultivates and supports a strong team culture and collaborative environment centered on consistently delivering exceptional performance and outcomes.

Essential Responsibilities and Tasks:

• Exhibit exceptional detail ensuring that CCPSA payments are posted with accuracy. Working daily to maintain payments stay current and ensure that payment batches balance.
• Posting to accounts all EFT payments and manual payments to correct accounts with balances being forwarded to Next Responsible Party.
• Working on Missing Payments queue to locate missing EOB’s to post payments to older accounts. This will entail navigating through insurance carrier web portals and calling the insurance to obtain the information as needed.
• Resolution of refunds for both insurance and patients including notation of details in to t refund issuance. Collaboration with RCM team members and insurance carriers to resolve payments not to be refunded.
• Reconciliation of banking transactions to accurately post zero pay EOB’s and post the denials accurately to the patient accounts.
• Compile and enforce all policies and procedures related to the position, the department, and the company.
• Promote the CCPSA culture of team collaboration, while identifying and implementing opportunities to enhance the shared values of the group.
• Proactive resolution of issues and timely response to questions and concerns including clear, timely, and accurate documentation.
• Work with RCM team to aggregate and identify trends to analyze (trending analysis).
• Other duties as assigned.

Skills, Education and/or Work Experience Requirements:

• Prior experience in a medical billing department is preferred but not required
• EPIC EMR with Resolute Professional Billing module working knowledge and experience preferred but not required.
• Extensive knowledge in the use of email, search engines, Internet; ability to effectively use insurance carrier websites; knowledge and use of Microsoft Products: Outlook, Word & Excel.
• Excellent written and verbal communication, organizational and time management skills with a high degree of drive, initiative and follow through in time sensitive task environment.
• Strong reasoning, critical thinking, analytical and mathematical skills.
• Ability to work independently, with high productivity, and regularly execute to deadlines.
• High School Diploma or GED required.

Physical Requirements:

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
• Ability to drive between clinic locations for meetings.
• Ability to sit for extended time periods.
• Must be able to lift and carry up to 30 lbs.
• Must be able to talk, listen and speak clearly on telephone.

Compensation:

• Competitive market adjusted pay.
• Benefits effective date-of-hire (no waiting period).
• Comprehensive medical benefits. Company covers 80-85% percent of individual or family premium.
• Dental and vision benefits – company covers 100% of individual or family premium.
• Life and AD&D benefits. Optional additional life & disability insurance at group discounts.
• PTO and holiday pay.
• 401k benefits with company contribution after eligibility period.