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

High school diploma or general education degree (GED);
3-4 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
Excellent written and verbal communication skills
Strong interpersonal skills and a high degree of collaboration at all levels
Excellent organizational skills, detail oriented, ability to prioritize, multi-task and meet deadlines
Intermediate customer service and phone skills
Excellent problem-solving skills and strong ability to complete complex claim analysis
Advanced with Microsoft Office, including Word, Excel and Outlook.

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

Billing and Collections Specialist 3

Key skills