Job Description
Join Tucson Health Solutions as a Senior Medical Biller and elevate your career in healthcare administration. We offer competitive compensation, comprehensive benefits, and a dynamic work environment where your expertise directly impacts patient care and revenue cycle management. Our commitment to excellence extends to our team, fostering growth through continuous training and professional development opportunities.
As a cornerstone of our revenue cycle team, you'll leverage cutting-edge billing software and industry best practices to ensure accurate and timely reimbursement. Enjoy a supportive culture that values precision, integrity, and innovation in medical billing. Apply today to become part of Tucson's premier healthcare provider.
Responsibilities
- Manage end-to-end medical billing processes for diverse healthcare specialties using Epic and NextGen EHR systems
- Submit clean claims to Medicare, Medicaid, and private insurers with <95% first-pass acceptance rate
- Resolve complex claim denials and appeals through meticulous documentation and payer negotiations
- Conduct regular audits to ensure compliance with HIPAA, CMS, and commercial payer regulations
- Maintain accurate patient financial records and payment histories in RCM platforms
- Collaborate with clinical teams to optimize charge capture and coding accuracy
- Generate monthly revenue cycle performance reports for department leadership
Qualifications
- 5+ years of medical billing experience with 2+ years in specialty billing (e.g., cardiology, oncology)
- Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) credential required
- Expert knowledge of CPT, ICD-10, and HCPCS coding with current CMS guidelines
- Proven proficiency in RCM platforms (e.g., Athena, eClinicalWorks) and EDI transactions
- Exceptional analytical skills with experience in denial root cause analysis
- Strong negotiation abilities with commercial payers and Medicare Advantage plans
- Ability to maintain 99.5% accuracy in claim submission and payment posting