Job Description
Job Description
Medical Biller & Insurance Enrollment Specialist
Job Summary : The Medical Biller & Insurance Enrollment Specialist is a hybrid role primarily responsible for leveraging the Athena EHR to ensure accurate charge posting, claim submission, timely adjudication, and optimal reimbursement. The hybrid role also involves insurance enrollment, including completing payer applications and maintaining provider schedules to ensure network participation and compliance. Key duties include charge posting, claim review, payment posting for select transactions, accounts receivable follow-up, and responding to inquiries from patients, staff, and management across multiple sites. As performance demonstrates capacity, this position may assume additional responsibilities within the revenue cycle. This is a nonexempt, full-time position in pay grade 4 with the pay range of $21.08 - $28.45. The Medical Biller & Insurance Enrollment Specialist reports directly to the Revenue Cycle Manager.
Required Skills / Abilities :
- Must be able to work independently and manage multiple priorities.
- Familiarity with FQHC billing and compliance regulations.
- Ability to work with others in a team base setting.
- Must possess a valid drivers’ license and have dependable transportation.
Education and Experience :
High School Graduate or equivalent; associate or bachelor’s degree preferred.A minimum of one to three years of experience in billing for a medical office, preferably in an FQHC environment.Prior experience with Athena is highly preferred.Credentialing experience is strongly preferred.Knowledge of CPT, ICD-10, HCPCS coding preferred. Experience in medical terminology is helpful.Working Conditions and Physical Requirements :
General office environmentOccasional travelStandards of Behavior :
Commitment To ServiceRespectQualityTeamworkPatient FocusIntegrityAccountabilityCaring & CompassionProfessionalismListening & RespondingSafetyAIDETJob Related Competencies :
Attention to Detail - The ability to process detailed information effectively and consistently.Problem Solving- Identifies and analyzes problems weighing the relevance and accuracy of available information. Generates and evaluates alternative solutions and makes effective and timely decisions.Communicates Effectively- Developing and delivering multi-mode communication that convey a clear understanding of the unique needs of different audiences.Values And Ethics - Serving with integrity and respect in personal and organizational practices. Ensuring decisions and transactions are transparent and fair.Time Management- The ability to effectively manage one’s time and resources to ensure that work is completed efficiently.Commitment to Community :
Choptank Community Health System (CCHS) is committed to creating a safe and open healthcare environment that improves health outcomes and values and respects the unique experiences and perspectives of both patients and staff by :
Prioritizing access for all individuals;Offering ongoing training for staff to promote health awareness, preventive measures and early detection for the varied patient population on the Eastern Shore;Actively engaging with patients, families and staff;Fostering a workplace culture in which everyone is treated with dignity.Duties / Responsibilities :
Medical Billing :Accurately process and post charges, submit claims through Athenahealth for all payers, including Medicaid, Medicare, and commercial insurance.
Review and resolve claim denials, rejections, and underpayments promptly.When needed, Post payments, reconcile accounts, and manage patient balances.Maintain compliance with FQHC billing guidelines and payer-specific requirements.Generate and analyze billing reports to identify trends and improve revenue cycle performance.Insurance Enrollment :Complete initial insurance enrollment for providers with insurance plans, Medicaid, Medicare, and other networks.
Maintain accurate provider records in credentialing databases and ensure timely updates.Track expirations for insurance contracts.Communicate with providers and payers to resolve enrollment issues efficiently.Regular, reliable attendance is a requirement of this job.Benefits :
Tuition and education assistanceCertification scholarships availablePaid holidays (9)Flexible paid time off and vacation scheduling403(b)403(b) matchingEmployee assistance programFlexible spending accountHealth insuranceDental insuranceVision coverageLife insuranceReferral programEmployee wellness programDiscretionary BonusesChoptank Community Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital or family status, veteran status, sexual orientation, gender identity or expression, genetic information, political affiliation, arrest record, or any other characteristic protected by applicable federal, state, or local laws. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.