SMCG Medical Billing Specialist, CPC

Medical Billing Specialist, Certified Professional Coder (CPC)

Location: North Houston - Hybrid
About SMCG

Sullivan Management & Consulting Group, LLC is a consulting and managed service organization specializing in healthcare. Our clients consist of private practices, hospitals, and healthcare organizations across multiple specialties. We offer services in Billing (RCM), Credentialing, Operations, Talent, Finance, and Marketing.

Job Overview

SMCG is looking for a Medical Billing Specialist to join Sullivan Management & Consulting Group, LLC (SMCG).

Your role will be to help analyze and improve billing practices for our clients, offering your expertise to help our clients implement best practices to ensure their collections are maximized.

To be successful in this role, you should have previous experience in medical billing and coding, preferably handling multiple providers or different specialties. The ability to produce and disseminate detailed reports will be vital to your capability to succeed at SMCG. If you are motivated and results-driven, and enjoy working in a team environment, we’d like to meet you.

Ultimately, you will help boost client revenue and contribute to SMCG long-term business growth.

  • Conduct audits and billing assessments, with capability to produce reports to be delivered to executive level stakeholders
  • Make sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations
  • Compliance with medical coding guidelines and policies
  • Implement strategic procedures and choosing strategies and evaluation methods that provide correct results
  • Deploy, maintain and report on various programs
  • Perform posting charges
  • Perform completion of claims to payers
  • Conduct duties in a professional and timely fashion
  • Submit billing data to the appropriate insurance providers
  • Process claims, ensuring accurate and complete information for every data point
  • Resolve denial instances and create denials appeals processes
  • Ability to look up ICD-10 diagnosis and CPT treatment codes
  • Handle patient communication directly as necessary
  • Follow HIPAA guidelines in handling patient information
  • Achieve maximum reimbursement for services provided
Requirements & Skills
  • Proven work experience as a Medical Biller or similar role
  • Solid understanding of billing software, electronic medical records, practice management software, and insurance policies
  • Must have the ability to multitask and manage time effectively
  • Excellent written and verbal communication skills
  • Strong attention to detail
  • Outstanding problem-solving and organizational abilities
  • Certified Professional Coder (CPC)

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