<p>About Our Company</p> <p>We're a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.</p> <p>Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.</p> <p>When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.</p> <p>Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.</p> <p>Job Description</p> <p>We are hiring at Starling Physicians, a VillageMD company!</p> <p>Could this be you?</p> <p>The Billing Specialist plays a vital role to the success of the medical group. The Billing Specialist will be responsible for reviewing all professional fee services performed in and out of the clinic setting. This position is responsible for making sure insurance is eligible and all authorizations/referrals have been captured prior to dropping claims. Additional responsibilities include validating coding for all assigned pre and post billing edits/rejections. To include validating correct CPT, Diagnosis, and Modifier usage for all assigned professional service claims. Billing Specialist are expected to maintain no more than 2-day charge lag and produce 900 charge items per day.</p> <p>While this role will be dynamic in nature, areas of responsibility are reviews information from patient's medical record necessary to properly correct edits/denials associated with evaluation and management services, surgical procedures, supplies dispensed and/or administered in office or clinic setting, and diagnoses. Key responsibilities and expectations of the position also include:</p> <p>How you can make a difference</p> <ul> <li>Reviews information from patient's medical record necessary to properly correct edits/denials associated with evaluation and management services, surgical procedures, supplies dispensed and/or administered in office or clinic setting, and diagnoses. </li><li>Inputs the appropriate codes/modifiers into the practice management system to rebill claims for proper payment. </li><li>Maintain communication with physician practice to facilitate denial and appeals review process. </li><li>Effectively utilize EMR system to review and validate coding as submitted on professional claims as assigned. </li><li>Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. </li><li>Process pre-billing clinical edits within department timeframes. </li><li>Payor and patient accounts payment posting </li><li>Checking eligibility and benefits verification for treatments, hospitalizations, and procedures. Maintain knowledge of managed care carrier clinical documentation, coding, and billing guidelines. </li><li>Maintain knowledge of governmental payer clinical documentation, coding, and billing guidelines. </li><li>Complete annual CEU requirements as determined by governing body for any billing/coding certification designations. </li><li>Other duties as assigned. </li></ul> <p>Skills for success</p> <ul> <li>Self-motivated: energetic, self-starter; can work autonomously with limited direction. </li><li>Results oriented: bias for action; demonstrated track record of achievement; drive for attainment of superior outcomes. </li><li>Flexible: ability to navigate within ambiguity; solution oriented. </li><li>Analytical: strong research, writing, analytical and critical reasoning skills. </li><li>Communication: conveys thoughts and expresses ideas effectively both verbally and in writing; strong presentation skills. </li><li>Collaboration: orientation to team-based work product and results. </li><li>Humility: low ego; engenders trust; respectful. </li></ul> <p>Experience to drive change</p> <ul> <li>Minimum high school diploma or equivalent. Associate Degree Preferred. </li><li>Required Certified Professional Coder (CPC) or HFMA Certified Revenue Cycle Representative (CRCR) or other equivalent certification, or willing to obtain certification within 6 months of employment. </li><li>Three (3) years specialized training in coding and/or professional fee billing office. </li><li>Knowledge of anatomy, physiology, medical terminology, disease process, evaluation and treatment. </li><li>Three (3) years of ICD-10-CM, HCPCS and CPT-4 coding experience </li><li>A minimum of three (3) years' experience working with a health care information systems/EMR ideally the Athena. Must demonstrate extensive knowledge of the current practice management software applications. </li></ul> <p>About Our Commitment</p> <p>Total Rewards at VillageMD</p> <p>Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.</p> <p>Equal Opportunity Employer</p> <p>Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.</p> <p>Safety Disclaimer</p> <p>Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.</p>