The Certified Billing Specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, analyzes expected reimbursement information and collections of government and commercial insurance payers. Additionally, reviews EOB’s and determines accurate account balance, detailed denial description, and applicable appeal process. Medical billing certification required. The ideal candidate must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. Must be able to demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims. Must demonstrate excellent written and verbal communication skills. 

Education:  This specialist must have a high school diploma and possess CCS credentials.

Experience: Must possess in-depth knowledge of medical and anatomical terminology, reimbursement principles, health record content, sequencing of diagnoses, and the use of coding software.