Job Description

Summary:

The Medical Billing Specialist II is responsible for accurately processing and managing medical claims, ensuring timely reimbursement from insurance payers, and resolving billing discrepancies. This role requires strong knowledge of CPT, ICD-10, and HCPCS coding, as well as experience with electronic health records (EHR) and billing software. The Specialist II will handle more complex billing tasks and provide guidance to junior billing staff as needed.

KEY RESPONSIBILITIES:

Prepare, review, and submit medical claims to insurance carriers accurately and in a timely manner. Verify insurance eligibility and benefits for patients. Research and resolve claim denials, underpayments, or billing errors. Collaborate with clinical and administrative staff to clarify patient information and coding issues. Maintain accurate billing records, reports, and documentation in compliance with federal, state, and payer regulations. Assist in training or mentoring new billing staff when needed. Stay current with changes in coding standards, payer policies, and billing regulations. Generate billing reports and analyze trends to improve revenue cycle efficiency

MINIMUM QUALIFICATIONS:

High school diploma or equivalent; associate's degree in healthcare administration or related field preferred. 2+ years of experience in medical billing or coding. Strong knowledge of CPT, ICD-10, and HCPCS coding. Proficiency with EHR systems (e.g., eClinicalWorks, Epic, Cerner) and medical billing software. Excellent attention to detail and problem-solving skills. Strong communication skills, both written and verbal. Ability to manage multiple priorities and work independently.

OTHER SKILLS AND ABILITIES:

Ability to work in a fast-paced environment. Preferred experience/knowledge of FQHC billing guidelines and procedures. Experience with eCW, a plus. Knowledge of healthcare governing agency policies and procedures. Knowledge of medical terminology. Must have good interpersonal/human relations skills. Ability to work independently and as part of a team Ability to work in a fast-paced environment

Working Conditions:

Prolonged periods of standing, bending or working at a desk on a computer. The ability to lift (up to 15lbs) is required.

Why work at CCI?

Extensive benefits plan including PTO 403B Retirement Plan + Employer match up to 4% Tuition reimbursement opportunities Continuing education assistance; can be used toward obtaining certifications, renewal of certifications, or possible conference attendance.

Our providers are insured for malpractice under FTCA.

Equal Employment Opportunity (EEO)

CCI Health Services does not unlawfully discriminate based on race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer related or genetic characteristics or any genetic information), marital status, sex, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. All personnel decisions are to be administered in accordance with this policy and in compliance with applicable federal and state law, including, but not limited to, decisions regarding recruitment, selection, training, promotion, compensation, benefits, transfers, lay-offs, tuition assistance, and social and recreational programs.
The CEO & President of CCI and all managerial personnel are committed to this policy and its enforcement. Employees are directed to bring any violation of this policy to the immediate attention of their supervisor, Human Resources, or the CEO & President. Any employee who violates this policy or knowingly retaliates against an employee reporting or complaining of a violation of this policy, shall be subject to immediate corrective action, up to and including termination of employment. Complaints brought under this policy will be promptly investigated and handled with due regard for the privacy and respect of all involved.