Medical Billing Specialist

3 days ago


Saginaw, Michigan, United States CMU Health Full time
Job Summary

**About CMU Health**

CMU Health is a leading healthcare provider seeking a highly skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will play a critical role in ensuring that patients and third-party payers are accurately billed and fees are collected for clinical services received.

Key Responsibilities

  • **Prioritize Daily Work**: Prioritize daily work to ensure achievement of established productivity and accounts receivable (A/R) goals.
  • **Claim Review and Release**: Review and release claims to payers in a timely and accurate manner.
  • **Claims Follow-up and Denial Management**: Effectively manage claims follow-up, aging, and denial work queues to ensure maximum reimbursement for services provided.
  • **Appeals and Reimbursement**: Initiate and track appeals following appropriate payer guidelines and ensure timely reimbursement for denied claims.
  • **A/R Management**: Identify issues impacting A/R and proactively communicate those issues to the Director, Revenue Cycle.
  • **Remittance and Posting**: Interpret government, commercial, workers' compensation, auto, and third-party liability remittance advices and make appropriate corrections to unpaid claims for resubmission. Post remittances, rejections, and adjustments to patient accounts.
  • **Collaboration and Communication**: Work effectively with clinical staff and other staff members of the Business Services Department to ensure seamless communication and coordination.

Requirements

  • **Experience**: Three years of medical billing experience, preferably within a multispecialty practice setting.
  • **Skills**: Proficiency with electronic medical records (EMR), Epic experience a plus.
  • **Certifications**: Medical billing-related credentials from a certifying institution preferred.


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