Billing Specialist II

This is a fully remote position, open to applicants in Alabama, +7 more states.

📋 Description

• Facilitate the timely and complete collection of revenue for designated groups

• Precisely code and input patient and charge data into the billing system

• Monitor high-value claims from charge entry to payment

• Address complex issues related to carrier, payer denials, authorizations, billing, payments, and claims

• Manage appeals, coding adjustments, medical necessity rules, re-bills, and medical documentation

• Assist auditors in evaluating notes for medical necessity

• Collaborate with the authorization department on intricate procedure authorization concerns

• Keep tracking logs for complex high-value procedures and report outcomes to billing management

• Liaise with Provider Service Representatives to resolve recurring payment problems

• Act as a resource for the Billing Staff regarding complex matters

• Maintain accounts receivable at no more than 10% overdue by over 60 days

• Process daily correspondence and inquiries regarding claim statuses

• Address billing inquiries from patients and internal staff

• Update patient files with changes to address and contact information

• Review policy modifications and notify the supervisor and charge entry specialist

• Navigate proprietary websites of insurance companies to research policies and payments

• Keep the supervisor informed about accounts receivable issues

• Respond promptly to requests from the billing company

• Review and manage claims in work-dashboard hold buckets

• Create, maintain, and update reports

• Uphold confidentiality and adhere to HIPAA regulations

• Assist in training new revenue cycle staff

• Collect and review end-of-day reports

• Regularly check work email throughout the day

• Complete necessary training and in-service sessions

• Perform additional assigned tasks

⛳️ Requirements

• High School Diploma or equivalent, with at least five (5) years of relevant experience; OR a comparable combination of education and/or experience

• Residence in MD, DE, VA, NJ, PA, FL, AL, GA, SC, or TX is required

• Proficient in Internet and Microsoft Office applications (MS Word, MS Excel, MS PowerPoint, MS Outlook)

• Outstanding written and verbal communication skills, along with exceptional customer service abilities

• Capability to build and maintain effective working relationships with physicians, clinical staff, colleagues, and the public

• Ability to work independently and as part of a team

• Competence in following verbal and written instructions

• Flexibility to work a varied schedule

• Ability to respond with patience and empathy during stressful situations related to patient health and emergencies

• Capacity to multitask and prioritize effectively

• High attention to detail

• Strong organizational capabilities

• Problem-solving skills and logical reasoning

• Ability to meet established quality standards

• Professional demeanor and appearance

• Working knowledge of CPT and ICD-10 coding standards

• Solid understanding of insurance policies and guidelines for third-party payers

• Familiarity with the healthcare sector, medical specialties, and medical terminology

• Strong commitment to delivering excellent customer service

• Adherence to relevant organizational policies and regulations

• High ethical and professional conduct standards

• Commitment to continuous professional development

• Reliable transportation

• Preferred: Two (2) years of experience with Electronic Medical Records (EMR)

• Preferred: Medical Billing Certification

🏝️ Benefits

• PTO: Up to 96 hours in the first year (pro-rated based on start date)

• 7 paid holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Day After Thanksgiving, Christmas Day

• 401(k) plan with employer matching

• Medical, dental, and vision coverage for individuals and families

• Short-Term Disability benefits

• Long-Term Disability benefits

• Basic Life/AD&D insurance

• Employee Assistance Program

• Optional Life insurance

• Accident insurance

• Critical Illness insurance

• Hospital Indemnity insurance

• Eligibility for overtime pay in accordance with applicable laws