Implementation Billing Specialist

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

📋 Description

• Oversee the complete medical billing process for clients during their implementation phase, which includes charge entry, claim submission, handling clearinghouse rejections, resolving denials, managing appeals, conducting payer follow-up, posting payments, secondary billing, and accounts receivable oversight.

• Assess the accuracy of claims and readiness for billing.

• Investigate instances of underpayments and claims that remain unpaid.

• Keep track of aging reports and compliance with filing deadlines.

• Reconcile ERA/EOB payments while identifying recurring issues with reimbursements.

• Manage and track implementation tasks, deadlines, unresolved issues, dependencies, and subsequent steps across various clients.

• Develop and document client-specific billing protocols, checklists, and standard operating procedures.

• Assist clients in navigating billing procedures, software workflows, claim specifications, and necessary documentation.

• Determine training requirements and provide ongoing support.

• Work collaboratively with the Implementation Manager, clients, billing operations, IT, as well as credentialing or contracting personnel.

• Offer backup coverage for routine updates to clients, implementation inquiries, scheduled training sessions, and follow-up coordination.

• Prepare comprehensive billing transitions to the ongoing billing team.

• Maintain precise implementation trackers and client documentation.

• Manage confidential information in compliance with HIPAA regulations.

⛳️ Requirements

• A minimum of five years of practical experience in medical insurance billing.

• In-depth knowledge of the entire billing cycle, from claim submission to payment posting and accounts receivable resolution.

• Strong expertise in claims and accounts receivable management, encompassing rejections, denials, appeals, payer follow-ups, ERA/EOB reconciliation, secondary billing, underpayments, aging reports, and timely filing regulations.

• Familiarity with medical insurance billing standards, especially concerning commercial insurance and Medicare.

• Capability to research payer requirements and understand relevant Medicaid, managed care, and Medicare DME billing standards.

• Exceptional organizational skills and the ability to independently manage multiple client accounts and prioritize competing deadlines.

• Strong problem-solving and analytical abilities, including root cause analysis, recognition of denial trends, recommendations for corrective actions, and escalation of intricate issues.

• Experience in documenting and enhancing workflows, developing procedures, identifying implementation gaps, and training clients or team members.

• Excellent communication and client service capabilities.

• Proficiency in EHR or practice management systems, clearinghouses, payer portals, spreadsheets, and task-tracking software.

• Ability to quickly learn new platforms.

• Must be legally authorized to work in the United States.

• Candidates must be at least 18 years old.

🏝️ Benefits

• Health insurance

• Paid time off

• Vision insurance

• Dental insurance