Job Description
Join our award-winning healthcare finance team as a Billing Specialist in the heart of Washington DC! Capital Healthcare Solutions is seeking a detail-oriented professional to optimize our revenue cycle management while delivering exceptional patient financial experiences. This hybrid role combines strategic financial analysis with hands-on billing operations in a dynamic, mission-driven environment.
Responsibilities
- Manage end-to-end medical billing processes including CPT/ICD-10 coding, claim submission, and AR follow-up
- Analyze complex insurance contracts to ensure accurate reimbursement and compliance with CMS regulations
- Resolve billing discrepancies through direct payer negotiations and documentation audits
- Develop process improvements to reduce claim denials and accelerate cash flow
- Collaborate with clinical teams to ensure charge accuracy and documentation completeness
- Generate monthly financial reports highlighting KPIs and revenue trends
- Maintain HIPAA-compliant patient financial records and billing documentation
Qualifications
- Bachelor's degree in Healthcare Administration, Finance, or related field (or equivalent experience)
- 3+ years of medical billing experience in hospital/clinic setting
- Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) credential preferred
- Expertise in Epic or NextGen EHR systems and medical billing software
- Advanced knowledge of Medicare/Medicaid/Commercial payer regulations
- Exceptional analytical skills with attention to financial detail
- Strong communication skills for cross-functional collaboration
- Experience with RCM optimization and denial management