About the role

WHO WE ARE

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

JOB SUMMARY

The Biller Specialist is responsible for the accuracy of the super bill/claim prior to transmission to payer, including validation of appropriate Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).

DUTIES & RESPONSIBILITIES

The Billing Specialist job description is intended to point out major responsibilities within the role, but it is not limited to these items.

Assign/remove CPT, HCPCS and modifiers as part of the super bill/claim validation process.
Prepare and review super bill/claims prior to submission.
Identify coding trends and opportunities to improve quality, efficiency and productivity.  
Checking each insurance payment for accuracy.
Ensure compliance with billing and payers’ guidelines.
Calling insurance companies regarding any discrepancy in payments if necessary
Researching and appealing denied claims.

EDUCATION AND PROFESSIONAL EXPERIENCE

(Licensures AND Certifications)

High school diploma or GED equivalent

Minimum of 1 year of experience as a medical biller.

PROFESSIONAL COMPETENCIES

Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Knowledge of CPT, ICD-10-CM and HCPCS codes.
Knowledge of coding principles and guidelines.
Knowledge of billing principles and guidelines.
Knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
Excellent written and oral communication skills
Prefer but not require American Academy of Professional Coder (AAPC) Certified Professional Coder (CPC) or American Health Information Management Association (AHIMA) Certified Coding Specialist (CCS).

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Skills & Tags

ai data product

Aplyr's read

Centrum Health (NeueHealth) is an innovative healthcare provider focusing on patient outcomes, attracting professionals passionate about value-based care and bilingual service delivery.
Synthesized from recent postings & public sources

What's promising

•Focus on value-based care attracts professionals committed to patient outcomes.
•Expanding network of clinics provides diverse opportunities for healthcare workers.
•Bilingual roles highlight commitment to serving diverse communities.

What to watch

•Limited public information about financial stability and growth plans.
•High demand for bilingual staff may limit applicant pool.
•Potential for role overlap in clinics could affect career progression.

Why Centrum Health (NeueHealth)

•Strong emphasis on bilingual capabilities to serve diverse patient populations.
•Focus on value-based care differentiates from traditional fee-for-service models.
•Recent hiring suggests growth and expansion in multiple geographic areas.

Aplyr’s read is generated by AI from public sources. Was it useful?