Job Description
Join our dynamic finance team as a Senior Billing Specialist at Pacific Health Solutions, a leading healthcare provider in San Diego. We're seeking a detail-oriented professional to optimize our revenue cycle management and ensure accurate billing operations. Enjoy competitive compensation, comprehensive benefits, and opportunities for career growth in our collaborative, innovative environment.
Responsibilities
- Manage end-to-end billing processes for complex medical claims and insurance reimbursements
- Resolve billing discrepancies through rigorous audit reviews and stakeholder collaboration
- Implement compliance protocols for HIPAA, CMS, and payer-specific regulations
- Develop analytical reports on billing performance metrics and revenue trends
- Train junior staff on billing systems and procedural best practices
- Leverage Epic EHR and NextGen practice management software for workflow optimization
- Coordinate with coding and clinical departments to ensure charge accuracy
Qualifications
- 5+ years of medical billing experience in a healthcare setting
- Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) credential
- Expertise in CPT/HCPCS coding, ICD-10 diagnosis coding, and UB-04 forms
- Advanced proficiency in billing platforms (Epic, NextGen, or similar)
- Strong analytical skills with experience in revenue cycle optimization
- Proven track record in reducing claim denials by 20%+
- Exceptional problem-solving abilities for complex insurance disputes