Billing Specialist

Role Overview

• Create billing reports of assigned agencies
• Submit accounts receivable claims and/or invoices for weekly/monthly billing of assigned agencies
• Reconciliation of assigned state or local agencies
• Research and resubmit of billings to assigned agencies
• Review quality assurance of all referrals or updated clients from assigned state or local agencies
• Make outbound & inbound calls, emails to assigned state or local agencies with the purpose of securing correct information regarding new referrals, updated clients, and billings
• Responsible for executing complex billing tasks, mentoring junior staff, and leading cross-functional initiatives
• Reduce payment agency backlog
• Perform in-depth audits of project data to identify and resolve billing discrepancies
• Demonstrate successful performance through accuracy, timeliness, and customer satisfaction metrics
• Utilize advanced Excel functions (e.g., VLOOKUP) and reporting tools in CRM and SharePoint
• Manage complex billing scenarios including denials, rejections, and aging accounts
• Collaborate with Posting teams to resolve discrepancies and support month-end close
• Prepare and submit electronic claims, paper claims, and invoices (CMS-1500, UBs, invoices, and payer portals, etc.)
• Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans
• Ensure accurate and compliant billing, following specific regulations of multi-state Medicaid and MCO's, Medicare Advantage, and Older Americans Act programs
• Responsible for ensuring aged outstanding balances of assigned payers is kept within department standards
• Participate in process improvement initiatives. Collaborate across teams to resolve issues, claims denials, and aging
• Other tasks as assigned, including but not limited to, assisting with projects that impact collections or write offs

Requirements

• High School Diploma or GED
• 2+ years of work-related experience in healthcare related field, ie, healthcare billing institutional and professional claims, patient registration, and/or patient access
• Intermediate level Excel skills
• Strong oral and written communication skills
• Ability to multi-task, set priorities, and pays close attention to detail
• Strong ability to work with team members across multiple departments
• Ability to work unsupervised with strong critical thinking and problem-solving skills
• Experience with Waystar, CRM, D365, and/or electronic health record platforms
• Must have a wired internet connection using an ethernet port. Broadband internet wired to the home is required
• Cable Modem/service or Fiber Optic. No Satellite, 4/5G, or DSL circuits
• Must have a quiet workspace that is free from distraction

Benefits

• PTO and benefits available after 30 days of employment
• Hybrid position offering the opportunity to work 3 days in the office and 2 days remotely