Billing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee daily billing processes to guarantee timely, accurate, and clean claims.

• Evaluate claims and address daily billing edits.

• Uphold payer-specific split billing requirements and keep the team crosswalk updated.

• Monitor changes from payers.

• Submit appeals via payer portals and provide feedback to the internal team.

• Import claims from the host system into the claims processing system as needed.

• Prepare and submit patient-service claims accurately, adhering to third-party payer guidelines and regulations.

• Review patient accounts and reconcile payments with secondary payers.

• Analyze remittance advice to ensure correct posting of payments.

• Address outstanding balances prior to filing with secondary payers.

• Ensure compliance with CMS regulations, HIPAA, and company policies in billing and collection practices.

• Maintain precise claim records and proper documentation for patient accounts.

• Achieve assigned daily productivity and quality benchmarks.

• Collaborate with patient financial services, finance, and billing departments on issues and disputes related to patient accounts.

• Assist management in maintaining or reducing accounts receivable days and enhancing organizational cash flow.

⛳️ Requirements

• Demonstrated experience in third-party insurance billing, collections, or patient accounts, ideally within a healthcare environment.

• Comprehensive understanding of billing codes, guidelines, and regulations.

• Knowledge of electronic health record (EHR) systems, billing software, and remittance advice processing.

• Excellent communication skills to articulate Medicare billing details and resolve patient inquiries.

• Capability to manage sensitive information confidentially in compliance with HIPAA regulations.

• Detail-oriented with strong organizational abilities and the capacity to handle multiple accounts at once.

• Problem-solving skills related to billing discrepancies and denied claims.

• Experience with payer portals, client systems, and clearinghouse requirements.

• 3–5 years of experience as a primary biller in a hospital business office.

• Preferred knowledge of medical terminology, ICD-10, CPT, DRG, and third-party insurance payer guidelines.

• High school diploma or equivalent.

• Additional training in medical billing is advantageous.

• Ability to communicate effectively with team members, management, and clients through email, phone calls, video meetings, and collaborative tools.

• A quiet, dedicated workspace free from distractions.

• Must ensure proper lighting and ergonomic setup.

🏝️ Benefits

• 100% remote work opportunity.

• Work-from-home arrangement.

• Stable internet connection and dedicated workspace provided.

• Access to required office equipment.