Job Description
Welcome to Nexus Health Systems, where precision meets compassion. We are currently seeking a detail-oriented and results-driven Billing Specialist to join our finance department in Oakland, CA. In this pivotal role, you will ensure the accurate and timely processing of medical claims, directly impacting our revenue cycle and patient care quality.
We offer a competitive benefits package, a collaborative work environment, and opportunities for professional growth within a leading healthcare organization.
Why Join Us?
- Competitive salary and comprehensive benefits package.
- Modern, inclusive workplace culture.
- Opportunity for career advancement in healthcare finance.
- Training and professional development resources.
If you are a proactive professional with a keen eye for detail, we want to hear from you.
Responsibilities
- Oversee the entire billing process, from claim submission to final payment, ensuring accuracy and compliance with all regulatory standards.
- Review and validate medical claims for errors in coding, documentation, and billing codes before submission to insurance payers.
- Monitor accounts receivable (AR) aging reports and follow up on outstanding balances and delinquent claims to maximize revenue recovery.
- Investigate and resolve claim denials and rejections by analyzing root causes and working with the clinical team to correct documentation as needed.
- Manage patient billing inquiries, provide explanations of benefits (EOBs), and facilitate payment plans to ensure a positive patient experience.
- Utilize electronic health record (EHR) and billing software to maintain accurate patient financial records and generate financial reports.
- Stay updated on changes in healthcare regulations, payer policies, and coding updates (ICD-10, CPT) to ensure compliance.
Qualifications
- Associate degree in Business, Healthcare Administration, or related field is preferred; high school diploma or GED equivalent required.
- Minimum of 2-3 years of experience in medical billing, claims processing, or revenue cycle management.
- Proficiency in medical billing software (e.g., Epic, Athenahealth, Cerner) and Microsoft Office Suite.
- Strong knowledge of CPT, ICD-10, and HCPCS coding guidelines.
- Familiarity with HIPAA regulations and healthcare compliance standards.
- Exceptional attention to detail and strong analytical problem-solving skills.
- Excellent verbal and written communication skills for interacting with patients and insurance representatives.