Medical Billing/Collection Specialist

Job Title: Billing/Collection Specialist
Location: Primary Care Practice Group (Clinics, ALFs, and SNFs)
Reports to: Billing Supervisor/Office Manager

Job Overview:

We are seeking a detail-oriented and proactive Billing/Collection Specialist to join our growing Primary Care Practice Group. This role will be responsible for managing billing processes and collections for our patient accounts across clinics, Assisted Living Facilities (ALFs), and Skilled Nursing Facilities (SNFs). The ideal candidate will must have a strong understanding of medical billing and collections, excellent communication skills, and the ability to work collaboratively with our team to ensure timely and accurate revenue cycle management.

Key Responsibilities:

• Billing:
• Prepare and submit accurate claims to insurance companies, Medicare, Medicaid, and other payers.
• Review and verify patient insurance information and ensure it is up to date.
• Ensure proper coding (CPT, ICD-10, HCPCS) for services provided in clinics, ALFs, and SNFs.
• Reconcile billing discrepancies and provide assistance in resolving coding errors.
• Respond to billing inquiries from patients and insurance carriers in a timely manner.
• Collections:
• Manage outstanding accounts by making collection calls and sending follow-up letters to patients and payers.
• Negotiate payment plans with patients and ensure timely follow-through on commitments.
• Work with patients to resolve unpaid balances and review patient financial assistance options when applicable.
• Maintain accurate records of collections activities and payments.
• Follow up on denied claims to ensure proper resolution and resubmission.
• Documentation and Reporting:
• Maintain detailed and accurate records of billing and collections activities.
• Prepare and submit regular billing and collection reports to management.
• Monitor aged accounts and provide recommendations for improvements to reduce aging.
• Compliance and Quality Control:
• Ensure compliance with all federal and state regulations, including HIPAA, regarding patient billing and collections.
• Stay current on insurance payer requirements and changes in healthcare regulations that may impact billing procedures.
• Collaborate with the clinical staff to ensure accurate documentation for billing purposes.

Qualifications:

• Education and Experience:
• High school diploma or equivalent; Associate's or Bachelor's degree in Healthcare Administration or related field preferred.
• Minimum of 2 years of experience in medical billing and collections, preferably in a primary care, ALF, or SNF setting.
• Knowledge of insurance guidelines (Medicare, Medicaid, commercial insurance), CPT, ICD-10, and HCPCS coding.
• Familiarity with healthcare billing software and Electronic Health Record (EHR) systems.
• Skills and Abilities:
• Strong attention to detail and ability to handle multiple tasks with accuracy.
• Excellent written and verbal communication skills.
• Ability to effectively interact with patients, insurance companies, and team members.
• Strong organizational skills with the ability to prioritize tasks in a fast-paced environment.
• Ability to work independently and collaboratively within a team setting.

Physical Requirements:

• Ability to sit for extended periods of time while performing office tasks.
• Ability to use a computer, telephone, and other office equipment.

Benefits:

• Competitive salary and benefits package - Pay based on Experience
• Health insurance, dental and vision coverage.
• Paid time off and holiday pay.
• Professional development opportunities.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Work Location: In person