Billing Specialist

About the role

We are seeking a Billing Specialist II to join our dynamic team at Cherry Health. This role plays a crucial part in ensuring that our services are properly reimbursed and patient accounts are managed accurately.

Responsibilities

• Review and post payments from all insurance, client, and third-party funding sources to ensure accurate patient financial records are maintained.
• Respond to billing and collection inquiries in a timely manner.
• Regularly work outstanding accounts receivable effectively and efficiently to meet accounts receivable management expectations.
• Process payer rejections and outstanding claims timely to ensure maximum reimbursement is received.
• Communicate and educate payer requirements and changes to front-end staff of your assigned locations.
• Research payer updates and requirements as needed and communicate with leadership on findings.
• Communicate tactfully with patients regarding bills by telephone, mail, and in person.
• Utilize the collection agency as stated in Agency policy.
• Aid and maintain reconciliation for annual cost reporting required by the Michigan Department of Health and Human Services (MDHHS).
• Post insurance and patient payments as needed.
• Serve as a mentor and role model by providing guidance, support, and training to team members.
• Maintain an approachable and collaborative demeanor to foster a positive and supportive work environment.
• Other duties as assigned.

Requirements

• Strong knowledge of medical billing processes, payer rules, and reimbursement methodologies, including Medicaid/Medicare and commercial insurance.
• Understanding of accounts receivable management, payment posting, and reconciliation procedures.
• Familiarity with payer rejections, denials management, and claims resubmission processes.
• Proficiency with electronic health records (EHR), practice management systems, and billing software.
• Strong analytical skills with the ability to research and interpret payer updates, identify discrepancies, and resolve issues.
• Effective written and verbal communication skills for professional interactions with payers, patients, staff, and leadership.
• Strong organizational and time-management skills to manage competing priorities, meet deadlines, and achieve A/R goals.
• Commitment to confidentiality, compliance, and accuracy in maintaining patient financial records.
• Adaptability to changing payer requirements, organizational needs, and workflow adjustments.

Skills / Knowledge / Abilities

• Strong knowledge of medical billing processes, payer rules, and reimbursement methodologies, including Medicaid/Medicare and commercial insurance.
• Understanding of accounts receivable management, payment posting, and reconciliation procedures.
• Familiarity with payer rejections, denials management, and claims resubmission processes.
• Proficiency with electronic health records (EHR), practice management systems, and billing software.
• Strong analytical skills with the ability to research and interpret payer updates, identify discrepancies, and resolve issues.
• Effective written and verbal communication skills for professional interactions with payers, patients, staff, and leadership.
• Strong organizational and time-management skills to manage competing priorities, meet deadlines, and achieve A/R goals.
• Commitment to confidentiality, compliance, and accuracy in maintaining patient financial records.
• Adaptability to changing payer requirements, organizational needs, and workflow adjustments.

Qualifications

• High school graduate or GED required.
• Certification from a certifying body dependent on assigned specialty required. Examples are the following: Certified Professional Biller (CPB), Community Health Billing and Coding Specialist (CH-CBCS), Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT), Certified Medical Reimbursement Specialist (CMRS).
• At least two years’ experience as a biller in a health care setting preferred, or an equivalent combination of education and experience sufficient to successfully perform the essential duties of the job listed above.

Benefits

• Loan repayment through the NHSC and Michigan State Loan Repayment Program for select roles.
• Medical, Dental and Vision Insurance for you and your family.
• Generous Paid Time Off benefit – 4 weeks per year for full time.
• Paid holidays - 8 full day paid holidays (Including Black Friday!) and 2 half day paid holidays!
• 403(b) Retirement Savings Plan with generous employer match - $ for $ match up to 5% MET and MESP 529 Savings Plans.
• Pet Insurance!
• Employee Assistance Program.