Billing Specialist

****This is a fully remote role****

If you are currently employed at Vivent Health, please log into UKG and submit your application through the My Company/View Opportunities page.

Get ready for something amazing! Imagine this: generous paid time off, including 12 paid holidays. And that’s just the start of the incredible perks you’ll enjoy at Vivent Health. There is 401k with 100% employer match up to 5%, 12 weeks of fully paid parental leave, employer subsidized medical, dental, vision benefits, and gender-affirming care benefits. And that's not even scratching the surface. Our complete package also includes employer paid short and long-term disability, tuition reimbursement, certification, and licensure assistance, and so much more. We also offer benefits for part-time roles! 

But here's the real deal. Your journey with Vivent Health isn't just a job. It's a chance to join an organization dedicated to fostering a workforce that reflects diverse backgrounds, perspectives, and experiences.  This makes you a part of something bigger and enables you to have a meaningful impact in our communities and the lives of the amazing patients we serve. 

Here are a few highlights of what working at Vivent Health may offer you: 

• Equity Practices: Fair treatment, access, and opportunities for all employees, creating an environment where everyone feels valued, respected, and empowered to contribute.
• Professional Growth: Opportunities for professional development and advancement, along with training programs and events that promote cultural competence, unconscious bias training, and awareness.
• Collaboration on an inter-disciplinary team: Within our integrated HIV care and prevention model, we employ a high level of collaboration across disciplines. That means that, in your role, you will have the opportunity to be exposed to whole person-care across medical, behavioral health, pharmaceutical, research, and more!
• Delivery of quality patient care: Our integrated HIV care and prevention model is proven to help patients achieve positive health outcomes.

YOUR CONTRIBUTION:

Deliver Excellence. Oversee with Integrity. Drive Progress. Exceed Expectations.

The Billing Specialist plays an integral role in our growing Healthcare Revenue team. This person is goal-oriented, compliant, revenue-driven, highly organized/accurate and motivated employee. This person is focused on all areas of the revenue cycle for specific Vivent Health Clinics and Departments.

OUR EXPECTATIONS:

Winning skills and behaviors for success.

Essential Job Duties

• Review medical records and assign appropriate diagnosis and procedure codes based on guidelines.
• Efficient and timely Revenue Cycle work within EPIC including: Charge Review, Claim Edit, Payment Posting, AR Follow-up, Refunds, Patient Support, and Billing Performance vs. Budget.
• The Billing Specialist works closely with the Clinic Department Manager, Health Services Administrator, Patient Services Representatives, Coders, EPIC Site Specialist and Vendors (Resolute Analyst, Contracting and Provider Enrollment) to ensure the entire Revenue Cycle is managed well.
• Monitor and follow up on outstanding claims, denials, and appeals to resolve billing discrepancies and ensure maximum reimbursement.
• Prepare and maintain billing reports, metrics, and documentation to track billing activities, revenue trends, and collections performance.
• Meet and exceed patient satisfaction expectations and goals aligned with Vivent health mission.
• Special Department or payer projects.
• Assist with payment posting, credentialing projects, fee schedule analysis and additional projects that support the Healthcare revenue cycle department.
• Other duties as assigned.
• Adhere to all agency policies, including but not limited to Confidentiality, Employee Handbook, Health Care Corporate Compliance Plan, Standards of Conduct, training, and other relevant policies.

NOTE: Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

KNOWLEDGE REQUIRED:

Required and preferred knowledge and experiences to succeed.  

• Education:
  • High school diploma or equivalent. Associates degree preferred.
• Work Experience:
  • Minimum of 2-3 years of experience in medical billing or healthcare revenue cycle management, preferably in a clinic or healthcare setting.
• Technical Experience:
  • Proficiency in EPIC Resolute Billing.
  • Excellent experience with Microsoft Office applications.
  • Experience with CPT and ICD-10 coding; familiarity with medical terminology.
  • Experience in filing claim appeals with insurance companies to ensure compliant, maximum reimbursement.
• Soft Skills:
  • Excellent customer service skills.
  • Strong written and verbal communication skills.
  • Meticulous attention to detail in reviewing billing codes, claims, and payments to ensure accuracy and compliance.
  • Strong analytical skills to identify trends, and address billing issues effectively.
  • Ability to manage relationships with various Insurance payers, including Credentialing Managers and Regional payer representatives.
  • Understanding of HIPAA compliance and responsible use of confidential information.
  • Ability to handle multiple projects and work courteously and respectfully with fellow employees, clients and patients.
  • Effective problem-solving skills and can-do attitude to resolve billing discrepancies, denials, and appeals in a timely manner.
  • Commitment to staying updated on industry trends, regulations, and best practices in medical billing and revenue cycle management.
• Additional Preferred Qualifications:
  • HIV experience in a not-for-profit environment.

STATEMENT OF INCLUSION:

Vivent Health is an equal opportunity employer and will recruit, hire, promote, and transfer qualified persons into all job classifications regardless of race, gender, religion, skin color, national origin or ancestry, physical disability (including pregnancy), mental disability, age, gender identity, sexual orientation, legally protected medical condition, family care status, marital status, veteran status, genetic characteristics, or any other characteristic protected by federal or state law. Vivent Health complies with other expanded protected classifications that specific county or municipal regulations may mandate.

Vivent Health is deeply committed to fostering respect, dignity, and understanding for all individuals affected by HIV, regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, or any other characteristic. We are dedicated to cultivating a supportive and inclusive environment that champions advocacy, education, and compassionate care for everyone in our diverse community.

Going beyond the law’s requirements, Vivent Health places great importance on fostering a culture that celebrates diversity, equity, inclusion, and belonging. We actively seek qualified candidates from different racial, cultural, and economic backgrounds, as we believe that differing perspectives and experiences make us stronger as an organization. Vivent Health encourages all interested persons to apply for this position, and we look forward to learning more about your unique background and qualifications.

As a recipient of federal funding, Vivent Health will not hire nor enter a contractual relationship with any party debarred, suspended, or excluded from federal assistance programs.

Salary Range:

$24.00/hourly - $25.00/hourly (Depending on Experience)

The final salary will be determined based on factors such as market data, internal equity, candidate experience and qualifications. Please note that it is uncommon for an individual to be hired at or near the top of the range.

Public Student Loan Forgiveness

Employment at our organization may qualify you for federal student loan forgiveness programs. We do not directly pay for – nor forgive – federal student loans; however, our status as a not-for-profit organization under Section 501 (c) (3), makes us an eligible employer. There may be other determining factors for one to qualify.

Please follow this URL to review one such program and their requirements:

https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service