Clinical Billing Specialist

Job Summary

Supporting the Care Management department, the full-time Clinical Billing Specialist will conduct charge audits, appeal payer denials, and assist with patient billing inquiries while working remotely during daylight hours.

Key responsibilities

• Appeal payer denials and coordinate payor audits, validating findings and negotiating outcomes
• Assist in monitoring and developing process improvement initiatives for regulatory compliance
• Support the Patient Business Services department with clinical billing inquiries requiring a clinical understanding

Required qualifications

• 5 years of varied nursing experience with a minimum of 3 years in a healthcare financial environment preferred
• B.S. degree in a healthcare-related field or Business Administration is preferred
• 2-5 years of patient account experience preferred
• Knowledge of CPT-4 and revenue coding is strongly preferred
• Familiarity with the Medipac system and related software is preferred