Billing Specialist

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

📋 Description

• Plan, coordinate, and execute activities associated with charging, billing, collections, and cash management.

• Assess, synchronize, devise, and implement billing processes tailored to critical access hospitals, rural health clinics, and facility-based workflows.

• Accurately and promptly process both electronic and paper claims.

• Address clearinghouse and DDE claim errors, as well as payer rejections.

• Follow up on claims that are underpaid or unpaid.

• Investigate and resolve reimbursement challenges, including medical necessity, coding discrepancies, and facility-specific billing criteria.

• Review post-insurance balances to ensure proper adjudication.

• Address overpayments and reconcile facility claims alongside cost-based reimbursements.

• Manage payer correspondence and take necessary actions.

• Maintain aging reports and handle accounts that are nearing timely filing limits.

• Resolve denied claims through reconsideration and appeals processes.

• Document account activities within the EHR system.

• Review and respond to accounts receivable reports.

• Prepare reports that highlight payer discrepancies and facility reimbursement concerns.

• Ensure accurate payer setup is maintained.

• Stay updated on CMS, Medicaid, and commercial payer regulations.

• Conduct reimbursement analysis.

• Monitor third-party payer contracts.

• Maintain proficiency in EHR, clearinghouse, and payer systems.

• Communicate escalated billing or payer issues to management.

• Participate in meetings, training sessions, and continuing education opportunities.

• Uphold professionalism and confidentiality at all times.

⛳️ Requirements

• High School Diploma is mandatory.

• An Associate’s or Bachelor’s degree is preferred.

• A minimum of 2 years of experience in medical billing is required.

• Experience in Critical Access Hospital (CAH) billing is strongly preferred.

• Hospital or facility billing experience is required.

• Rural Health Clinic (RHC) billing experience is preferred.

• Familiarity with facility-based claims, UB-04 billing, and payer reimbursement methodologies is essential.

• A strong understanding of medical and insurance terminology is required.

• Proficiency in Microsoft Office is necessary.

• Knowledge of Nebraska payer rules is an advantage.

• A stable internet connection, dedicated workspace, and access to necessary equipment are required.

• Ability to communicate consistently through phone, email, and video conferencing is essential.

• Capability to access confidential information while adhering to privacy and security policies is necessary.

🏝️ Benefits

• Opportunity to work from home with a reliable internet connection, dedicated workspace, and necessary equipment.

• Remote work is expected to be 100% of the time.

• Participation in training sessions and continuing education opportunities is included.