Billing Specialist

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

📋 Description

• Oversee daily billing activities to ensure claims are processed accurately and on time.

• Analyze claims and address any daily billing claim modifications.

• Uphold split billing criteria as per payer specifications and keep the team informed on updates.

• Track payer modifications and submit appeals via payer portals.

• Import claims into the claims processing system as needed.

• Prepare and submit precise patient-service claims in alignment with payer guidelines and regulations.

• Review patient accounts and balance payments with secondary payers.

• Examine remittance advice to guarantee correct posting of payments.

• Resolve outstanding balances prior to filing with secondary payers.

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

• Maintain precise claims records and documentation within the patient account system.

• Achieve assigned daily productivity and quality benchmarks.

• Collaborate with patient financial services, finance, and billing departments to resolve patient-account matters or disputes.

• Assist management in 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.

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

• Excellent communication skills, including the ability to explain Medicare billing details and address patient inquiries.

• Capability to manage sensitive information and uphold confidentiality in compliance with HIPAA regulations.

• Detail-oriented with exceptional organizational skills and the ability to handle multiple accounts concurrently.

• Proficient problem-solving skills for addressing billing discrepancies and denied claims.

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

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

• Knowledge of Medical Terminology, ICD-10, CPT, DRG, and guidelines from third-party insurance payers.

• High school diploma or equivalent required.

• Familiarity with TruBridge and SSI is an advantage.

🏝️ Benefits

• Opportunity to work from home or a remote location.

• Stable internet connection and a dedicated workspace provided.

• Necessary office equipment supplied.

• Daily communication facilitated through email, phone calls, video meetings, and collaborative tools.