Claims and Billing Specialist

The Opportunity 

Cala Health is seeking a Claims and Billing Specialist to join our team. This team member will be responsible for managing the billing and claims process. This is a crucial role in ensuring accurate and efficient billing processes, maintaining financial integrity, and providing excellent customer service.

The compensation range for this role is market driven, with a salary range of $65,000 - $105,000. Additionally, we offer a robust benefits package. This offering is aligned with our overall compensation philosophy. 

 The Opportunity: A Day in the Life 

• Provide prompt and knowledgeable responses to emails and phone calls ensuring that all inquiries are addressed with accuracy and efficiency
• Ensure that all communication is promptly documented in appropriate system of record, facilitating easy access to information and maintaining a comprehensive and reliable record of interactions
• Review patient documentation to ensure accuracy and qualification, maintaining high standards of thoroughness and diligence
• Manage shipments by approving and generating sales orders, promptly sending sales orders to ship and reviewing sales orders for accuracy after shipment ensuring smooth processing and timely delivery; confirm sales orders to create claims and invoices, maintaining high standards of accuracy in financial transactions
• Utilize multiple billing channels to efficiently process claims and invoices through electronic, paper and credit card payment methods
• Monitor patient billing module and update information as needed
• Collaborate with clients and cross-functional departments to identify potential risks and solutions for enhancing performance
• Review sales order reports; complete reports as needed
• Provide assistance and guidance to new and emerging business models, aiding in their development and implementation
• Actively support company goals, objectives, policies and procedures, ensuring alignment and adherence throughout their work
• Perform other duties as assigned, contributing to the overall productivity of the department

 Qualifications, Skills and Experience 

• Bachelors or Associates degree in Business or Finance preferred; high school or GED equivalent required
• 2+ years of DME accounts receivable billing experience required
• Medicare experience and Brightree and Salesforce Software knowledge strongly preferred
• Strong computer skills; proficiency in Microsoft and Google products required
• Self-starter who takes initiative to overcome challenges and problem solve
• Excellent written and verbal communication skills
• Must be detail oriented and able to plan, organize and complete tasks in a timely manner
• Ability to multi-task and work independently