Sr Medical Biller

Description

Reporting to the RCM Manager,  Community Medical Services (CMS) is hiring a Senior Medical Biller. This role will be responsible for analyzing, reporting and trending the impact of multi-state and multi-payer AR work processes. The ideal candidate will have experience with Medicaid, Medicare, Veteran Affairs and commercial lines of business. The candidate will also be responsible for managing high volume insurance plans or national contract payers. This role will identify claim denials and payment trends and work directly with payers to resolve using projects and appeals processes.  

As part of our mission to help individuals recover from substance use disorders, you’ll thrive in a supportive, engaging, and fulfilling work environment where your contributions are valued.

Along the way, we’ll invest in your well-being through a benefits package that includes:

• Subsidized medical, dental, and vision insurance
• Health savings account
• Short and long-term disability insurance
• Life insurance
• Paid sick, vacation, and holiday time
• 401K retirement plan with match
• Tuition and CME reimbursement up to 100%
• Employee assistance program to support your mental health and wellness
• Ongoing professional development 

Responsibilities

• Experience with Medicaid, Medicare, Veterans Affairs and Commercial line of business.
• COB processing.
• Independently analyzing and reporting the impact of existing AR work processes.
• Managing high volume insurance plans or national contract payers.
• Monitor claim volume and payments for assigned payers to maintain accuracy.
• Assist with developing new processing steps for managing AR.
• Remain current on multi-state billing and coding procedures and changes.
• Excellent communication skills.
• Work with cross functional Community Medical Services Teams, like Clinical Operations, Quality Management, and Credentialing.
• Problem solver, using data driven decision making.
• Detail orientation with the ability to handle multiple assignments promptly and effectively.
• Experienced with using Microsoft Windows, Outlook, Word, Excel.  
• Other duties as deemed necessary to include finance responsibilities.

Qualifications

• 5-7 years full cycle medical billing experience required
• HS Diploma or GED required
• Billing certification a plus
• Strong Knowledge of CPT/ICD10 coding, insurance cards, and medical benefits.
• Run and utilize weekly aging AR reports to follow up on outstanding claims, and bulk process for claim resolution
• Ability to handle multiple projects independently and adhere to deadlines
• Experience with Kipu a plus

Tools and Equipment Requirements 

• Ability to use a phone, computer, printer, and copier is required 
• Frequent use of Microsoft Office products (Word, Excel, PowerPoint, etc.)  
• Ability to use the internet and various web browser software is required 
• Frequent use of electronic health record to document patient encounters 

Physical Working Conditions

• Requires sitting, standing, and bending associated with a office environment 
• Some lifting may be required 

 #CRPSF 

Requirements

About Community Medical Services

Community Medical Services (CMS) is a CARF-accredited addiction treatment program providing services in the form of outpatient medication-assisted treatment and one-on-one and group counseling to those seeking help with their opioid use disorder. Headquartered in Arizona with more than 70 treatment clinics in 14 states, CMS is dedicated to meeting the challenges presented by the growing opioid epidemic in communities where treatment is lacking.

Our Commitment

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Other Conditions

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.