Billing Specialist

Position Description:

The Billing Specialist is responsible for the timely and effective collection of outstanding patient and insurance balances. This includes conducting follow-up on aged accounts, resolving denied claims, and handling inbound and outbound calls from patients, payers, and internal stakeholders. The role is critical to optimizing cash flow, minimizing bad debt, and ensuring patient satisfaction. This is a full-time role working 40 hours a week 8am-4:30pm. This is a remote position with beginning training in person as well as occasional in-person meetings.

Essential Duties and Responsibilities:

• Aged AR Management:
• • Analyze and prioritize aged accounts for follow-up based on aging buckets and balance thresholds.
  • Initiate timely follow-up with payers and/or patients to resolve unpaid claims and balances.
  • Document all follow-up activities, findings, and outcomes in the billing system.
• Denial Resolution:
• • Review and interpret payer denials.
  • Take corrective actions such as claim corrections, appeals, and resubmissions.
  • Identify trends in denials and report issues to the appropriate team or supervisor.
• Phone Call Management:
• • Answer incoming patient calls regarding account balances, claim status, and payment arrangements.
  • Make outbound calls to patients and insurance companies to follow up on unpaid claims and balances.
  • Professionally and empathetically assist patients with billing questions and concerns.
• Coordination and Communication:
• • Collaborate with front office, clinical teams, and billing team members to resolve account issues.
  • Escalate complex or high-dollar issues to supervisors when necessary.
  • Maintain confidentiality and compliance with HIPAA and all applicable regulations.
• Reporting and Metrics:
• • Meet individual productivity and quality standards as defined by department benchmarks.
  • Assist in preparing reports on unresolved accounts, denial trends, and collection efforts.
  • Validates claim processing to ensure compliance with payer contracts.
  • Complete insurance payments, adjustments, offset payment and refund posting as needed.

Skills and Competencies:

• Strong knowledge of insurance guidelines (commercial, Medicare, Medicaid)
• Excellent verbal and written communication skills
• High attention to detail and accuracy
• Ability to handle a high call volume professionally
• Problem-solving skills and initiative
• Customer service mindset with a calm, respectful demeanor
• Ability to work independently and meet deadlines

Qualifications:

• Education: High School Diploma or GED required; Associate's Degree or certification in medical billing preferred.
• Experience:
• • Minimum 1-2 years of medical billing or AR follow-up experience in a healthcare setting.
  • Experience with denial management and working payer portals is strongly preferred.
  • Familiarity with EHRs, billing software (e.g., Encoda, Epic, eClinicalWorks), and Excel.

You will also be eligible for the following benefits:

• Medical, Dental, Vision.
• Life Insurance and Long-Term Disability
• Retirement Savings Plans
• Paid Time Off