Billing Specialist

Who We Are: Central City Health (CCH) has been serving the under-housed and at-risk population in metro Detroit since 1972, by providing integrated healthcare services. Our services include primary and pediatric care, dental care, behavioral and SUD care, supportive housing, and community re-entry services, to name a few. In 2024, our President/CEO, Dr. Kimberly Farrow-Felton received the esteemed Healthcare Hero Award from Crain’s Detroit Business honoring her exceptional contributions to the health and well-being of our community.

 

Our Mission: To achieve wellness in the community by providing an array of primary and behavioral health care, housing, and substance abuse services with dignity and respect.

 

Our Core Values: CCH is guided by a set of values in fulfilling our mission.

 

Some of our values include:

• An environment that supports health and recovery.
• Person centered principles in the delivery of care.
• An environment characterized by cultural sensitivity, integrity, teamwork and trust.
• A commitment to service excellence and continuous quality improvement.
• Persons served take both an active part in their treatment and the organization.
• An atmosphere of welcoming and accessibility to people seeking our services that assures “no wrong door.”

You Get:

• 14 Paid Holidays Annually.
• 18 PTO Days (less than 1 Year; 27 Days on 1st Year Anniversary).
• Benefit Coverage after 30 Days: Medical/Dental/Vision/Short-term Disability.
• Company-Paid Life Insurance.
• Retirement Savings 403(b).
• Tuition Reimbursement.
• Continuing Education Allowance.

Job Summary:

The Biller will work to bridge the gap between health care providers, patients, and the insurance companies by making sure the correct information is updated and added to the electronic medical record before transmitting claims. This individual will ensure timely and accurate reimbursements by batching, reviewing, and correcting any internal claim errors before submission to the electronic billing clearinghouse. Upon claim submission to the proper clearinghouse, the biller will review the uploaded claims to correct any front-end edits that could prevent the claim reimbursements. While working through the billing process, the medical biller is also responsible for posting (and recording) claim payments received, following up on non-paid claims to correct for reimbursement in a timely manner and processing any corrected and/or VOID claims. The medical biller should understand how to manage patient information in accordance with HIPAA regulations, know how to locate and understand provider manuals.

 

Responsibilities:

• Prepares claims for various service lines (behavioral health, primary care, SUD, etc.)
• Under supervision, analyze, research, and resolve various claims-related issues.
• Initiates investigation of questionable claim.
• Keeps management abreast of claims related issues.
• Completes required reports as requested.
• Interacts verbally and in writing with fellow team members through the company.
• Maintains confidentiality of patient information.
• Refers complex or unusual issues to the Revenue Cycle Manager.
• Meets production quantity and quality standards, as determined by Leadership.
• Participates in a team concept, which promotes an effective and efficient department.

Education & Experience:

• High school graduate or equivalent required; Two (2) years of college preferred.
• Minimum of two (2) years of recent medical billing experience preferred.
• Knowledge of behavioral health, professional and facility claims processing.
• Basic experience with ICD-10 and CPT coding.
• Knowledge of FQHC and Community Mental Health claims preferred.
• Basic knowledge of applying appropriate modifiers.
• Problem solving and research skills; analytical, communications and critical thinking.
• Interacts with Medical Services, Mental Health Services and Dental Services.

“This is an outline of the primary responsibilities of this position. As with everything in life, things change. The tasks and responsibilities can be changed, added to, removed, amended, deleted, and modified at any time by the organization. CCH is an Equal Opportunity Employer committed to a culturally diverse workforce. We are committed to providing an inclusive environment based on mutual respect for all candidates and team members. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, height, weight, marital status, gender identity expression, disability status, protected veteran, or other legally protected status by state or federal law. At CCH the health and safety of our employees is our top priority. Vaccination has been proven to play a critical role in combating COVID-19. As a result, CCH prefers that employees are fully vaccinated against COVID-19; however, it is not required.”