Billing and Collections Specialist

Job Overview:

We are seeking a detail-oriented Billing and Collections Specialist to manage insurance appeals, denials, patient pay collections, unapplied payments, order confirmations, and other revenue cycle tasks. The ideal candidate will have experience with Brightree and knowledge of diabetes supplies and equipment. This role is key in ensuring timely payments and efficient account management.

Work Environment:

This position offers flexibility in terms of location, with the possibility of remote work based on business needs and team collaboration.

Key Responsibilities:

1. Insurance Appeals & Denials:

• Review and process insurance denials and rejections.
• Identify and correct issues leading to denials and work to resolve them promptly.
• Prepare and submit appeals for denied claims, ensuring accurate documentation and adherence to deadlines.
• Communicate with insurance carriers to resolve discrepancies and facilitate claim approvals.

1. Patient Pay Collections:

• Handle patient billing inquiries, clarifying charges and payment options.
• Contact patients regarding outstanding balances and payment plans.
• Process patient payments and follow up on overdue accounts.
• Negotiate and set up payment arrangements with patients as necessary.

1. Unapplied Payments:

• Research unapplied payments, ensuring they are correctly applied to patient or insurance accounts.
• Work with accounting and billing teams to resolve payment application issues.
• Monitor and update unapplied payment records to ensure proper allocation.

1. Revenue Cycle Management:

• Assist with overall revenue cycle operations, from the initial billing process to final payment.
• Work collaboratively with the customer service, and sales team to address billing-related concerns.
• Maintain accurate, up-to-date records of all claims and payments.
• Ensure compliance with federal and state regulations, as well as company policies.

1. Software and Systems Management:

• Utilize Brightree and other relevant software to manage billing and collections functions.
• Maintain knowledge of the latest billing practices, codes, and regulations in the medical supply industry.
• Update and manage patient and insurance accounts within the system.

1. Industry Knowledge & Communication:

• Utilize knowledge of diabetes supplies and equipment to accurately bill and resolve issues related to specific products and services.
• Provide excellent customer service to both insurance companies and patients, ensuring positive relationships and clear communication.

Qualifications:

• Proven experience in billing and collections within the healthcare or medical supply industry.
• Experience working with Brightree is highly preferred.
• Strong understanding of insurance appeals, denials, and reimbursement processes.
• Knowledge of diabetes supplies, and equipment is a significant advantage.
• Familiarity with revenue cycle management best practices.
• Strong communication skills, both written and verbal.
• Excellent attention to detail and organizational skills.
• Ability to manage multiple priorities and meet deadlines.
• High school diploma or equivalent; additional certification or education in medical billing, healthcare administration, or a related field is a plus.

Additional Skills:

• Proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Ability to analyze complex billing issues and resolve them efficiently.
• Strong problem-solving skills and the ability to think critically.

If you're a motivated professional with a passion for healthcare billing and collections, and you meet the above qualifications, we encourage you to apply to become part of our team.