Billing Specialist
Evergreen Family Medicine is committed to providing excellent care for your family with clinics in Roseburg, Sutherlin and Myrtle Creek Oregon. Evergreen Family Medicine serves outpatient needs, including Urgent Care, Family Practice, Women's Health, Occupational Health, and school-based telehealth.
Evergreen Family Medicine is a Drug Free Workplace. All candidates that are offered employment will be required to pass a pre-employment drug screen and background check.
Responsibilities and Duties :
- Maintains confidentiality according to HIPAA regulations and EFM policies.
- Adheres strictly to EFM departmental standards and policies, including state and federal regulations.
- Communicates effectively and professionally with co workers, managers and patients via phone, email or in person.
- Schedules work flow and establishes priorities for timely billing and follow up.
- Ensures all Hold claims lists assigned are worked on a weekly basis.
- Identify ongoing issues and trends that can be corrected or improved in areas affecting billing; these may include areas of posting, claim hold's, take backs, kick codes, or insurance.
- Ensures AR postings of all insurance payments and refunds.
- Works with front office staff, to ensure that all patient information is correctly entered and processed for billing.
- Collects patient co-pays, self pays, and patients balances and process payments via phone calls from patients.
- Responsible for maintaining communication with insurance companies on any changes affecting billing for EFM. Maintaining login's for assigned insurance companies.
- Working knowledge and training of current EFM computer systems used to complete billing.
- Ensures on a daily basis to promote an environment filled with teamwork, a positive outlook and constant professionalism.
Qualifications and Skills :
Education & Certifications
High school diploma or equivalent (minimum).Preferred : Associate's degree in healthcare administration, business, or related field.Certification : Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or equivalent preferred.Technical & Professional Skills
Medical Billing Expertise :Strong understanding of ICD-10, CPT, and HCPCS coding.
Familiarity with EHR / EMR systems and practice management software.
Knowledge of insurance claim processes, denials, take-backs, kick codes, and appeals.
Experience posting payments, adjustments, and refunds accurately.
Regulatory Knowledge :Demonstrated understanding of HIPAA compliance and patient confidentiality.
Knowledge of state and federal billing regulations.
Computer & Technical Proficiency :Proficiency with Microsoft Office Suite (Word, Excel, Outlook).
Ability to manage insurance company portals and maintain logins.
Quick learner with new billing software and systems.
Experience
3+ years of medical billing experience (preferably in a clinical or specialty practice setting).Proven track record of working insurance claims, AR management, and patient collections.Experience collaborating with front office and clinical staff to ensure billing accuracy.Soft Skills & Core Competencies
Communication : Clear, professional communication with patients, providers, coworkers, and insurance companies.Attention to Detail : High level of accuracy in data entry, coding, and claims review.Analytical Skills : Ability to identify billing trends, resolve recurring claim holds, and recommend process improvements.Organization & Prioritization : Skilled in managing multiple claims, payments, and deadlines simultaneously.Problem-Solving : Proactive in resolving claim denials, patient billing concerns, and workflow bottlenecks.Teamwork : Positive attitude, promotes collaboration, and contributes to a professional work environment.Confidentiality : Strong sense of ethics and commitment to protecting sensitive patient information.Physical requirements :
Prolonged periods sitting at a desk and working on a computer.The employee is frequently required to walk; use hands and fingers, handle, or feel; and reach forward with hands and arms.The employee is occasionally required to sit and stoop, kneel, or crouch.Must be able to lift up to 35 pounds at times.Our culture and values are every employee's responsibility : The needs of our patient come first S.P.I.R.I.T
StewardshipPatient & Population Focused Health CareIntegrityRespectInnovationTeamworkBenefits :
Health, Dental, Vision benefitsLife Insurance401k with a company match up to 6%Paid Time Off