Billing Specialist II

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

📋 Description

• Facilitate the thorough and timely collection of revenue for designated groups.

• Precisely code and input patient and charge details into the billing system.

• Monitor high-value claims from the point of charge entry through to payment.

• Address intricate carrier issues and follow up on outstanding complex claims and charges.

• Examine and resolve payer denials, including appeals, coding adjustments, medical necessity protocols, and related tasks.

• Aid auditors in reviewing documentation for medical necessity.

• Collaborate with the authorization department to address authorization challenges for complex procedures.

• Maintain tracking logs for complex high-value procedures and communicate results to billing management.

• Liaise with Provider Service Representatives to resolve recurring payment issues.

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

• Analyze and rectify billing discrepancies, ensuring accounts receivable remains at no more than 10% overdue by 60 days.

• Process daily correspondence, claim statuses, denials, appeals, and rebills.

• Address billing inquiries from patients and internal staff.

• Update patient records with changes to address and contact details.

• Review policy modifications and inform the supervisor and charge entry specialist.

• Navigate insurance company websites to locate policies and investigate payments.

• Keep the supervisor informed about accounts receivable issues.

• Respond swiftly to requests from the billing company.

• Investigate denials and submit corrected claims along with necessary medical documentation.

• Review and manage claims within dashboard hold buckets.

• Create, maintain, and update reports as necessary.

• Uphold confidentiality and comply with HIPAA regulations.

• Assist in training new revenue cycle personnel.

• Collect and review end-of-day reports.

• Regularly check work email throughout the day.

• Complete all required training sessions and in-services.

• Perform other assigned responsibilities.

⛳️ Requirements

• High School Diploma or equivalent with a minimum of five (5) years of relevant experience; OR an equivalent combination of education and/or experience.

• Must reside in one of the states where the company operates: MD, DE, VA, NJ, PA, FL, AL, GA, SC, or TX.

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

• Exceptional written and verbal communication skills, including outstanding customer service.

• Ability to establish and maintain effective working relationships with physicians, clinical staff, colleagues, and the public.

• Capability to work independently as well as part of a team.

• Ability to follow both verbal and written instructions.

• Willingness to work a flexible schedule.

• Patience and understanding in stressful situations related to patient health and emergencies.

• Competence in multitasking and prioritizing responsibilities.

• Strong attention to detail.

• Excellent organizational skills.

• Problem-solving and analytical abilities.

• Capability to meet defined quality standards.

• Professional demeanor and appearance.

• Working knowledge of CPT and ICD-10 coding standards.

• Solid understanding of insurance protocols and third-party payer guidelines.

• Familiarity with the healthcare sector and medical specialties, as well as medical terminology.

• Strong commitment to providing exceptional customer service.

• Adherence to the rules and regulations of accountable organizations.

• High ethical and professional conduct standards.

• Desire for continuous improvement in professional performance.

• 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) with employer matching.

• Medical, dental, and vision insurance for individual and family coverage.

• Short-Term Disability coverage.

• Long-Term Disability coverage.

• Basic Life/AD&D insurance.

• Employee Assistance Program.

• Optional Life insurance.

• Accident insurance.

• Critical Illness insurance.

• Hospital Indemnity insurance.

• Eligibility for overtime pay as per applicable law.