Billing and Collections Specialist

Role Overview

• The Billing and Collections Specialist is responsible for the timely follow-up of claims billed and resolution of accounts.
• Oversees the account receivables and maintain detailed/accurate account documentation.
• Appeal and/or rebill all open, underpaid/unpaid claims thoroughly, accurately, promptly, and with all supporting documentation
• Identify and complete Medical Necessity appeals
• Responsible for maintaining and updating payor billing and collection guidelines, fee schedules, etc.
• Report all payor issues and/or denial trends to Lead/Supervisor
• Work cross-functionally to complete multiple department assignments
• Review, document, and resolve all incoming correspondence, payor calls, and payments; Assist as needed
• Assist in continuous training and cross-functional efforts
• Other duties as assigned

Requirements

• High school diploma or general education degree (GED); and three to four years’ related experience and/or training; or equivalent combination of education and experience
• 4-5 years medical billing and claims reimbursement experience; preferred
• Knowledge of all Government, Commercial and Private payers; required
• Knowledge of medical and billing terminology; required
• Knowledge of HIPAA and other industry specific regulations; required
• Knowledgeable of all companies and modalities; required (Internal)
• Enrolled as Billing & Collections Specialist 2 for a minimum of 1 years; exceptions with manager approval

Benefits

• For more information on our industry-leading benefits, please visit our benefits page here