The Billing Specialist, reporting to VP MSO, will be responsible for performing all aspects of the medical billing cycle to ensure timely processing and payments of medical visits and procedures.

Essential Duties and Responsibilities:

• Maximize billing and collections by ensuring all functions of the medical billing cycle are being performed efficiently and timely
• Run daily and monthly reports and queries and takes action to resolve issues
• Process prior authorizations for medical procedure(s) and verify patient insurance
• Assemble and submit claims
• Post charges and payments
• Mange overdue accounts and ensure payment is received
• Investigate and re-file rejected claims

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Required Education and Experience:

• Bachelor's degree in Finance, Accounting, business or other comparable experience preferred
• Five (5) years of experience in medical billing and coding

Knowledge, Skills, and Abilities:

• Knowledge of ICD-9, ICD-10 and CPT coding
• Knowledge of commercial government insurance guidelines, medical terminology, and HIPAA standards
• Acute attention to detail
• Self-starter who will take initiative and be proactive and can manage multiple, competing priorities with minimal oversight
• Strong interpersonal and communication skills with patients and staff in a professional and courteous manner
• Understanding of healthcare workflows for population health, value-based care, and care management, as well as the ability to think through workflows and any implications from suggested changes
• Proficient in Microsoft applications including Word, Excel, PowerPoint and other web-based applications
• Understands and complies with highest standards of confidentiality.

Physical Requirements

• This job operates in a professional setting. While performing the duties of this job, the employee is regularly required to sit or stand for extended periods of time. Normal manual dexterity is required.
• Normal speaking and hearing abilities to interact with others in an office environment, over telephone or other video conferencing platform.
• The employee is occasionally required to stand; walk; and reach with hands and arms and continuously repeat the same hand, arm finger motion many times as in typing.

Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.