Medical Billing and Accounts Receivable Specialist

Description

Job Title: Medical Billing and Accounts Receivable Specialist

Job Description:
We are seeking a skilled and detail-oriented Medical Billing and Accounts Receivable Specialist to join our organization. This position is integral to the financial operations of our practice, focusing on the accurate management of billing processes, resolution of outstanding claims, and timely collection of payments from insurance carriers and patients. The successful candidate will demonstrate a high level of professionalism, a strong understanding of healthcare billing processes, and the ability to work effectively in a dynamic, fast-paced environment.  Please note that applications that are thoroughly completed and identifying work experience skills and experience that are a positive match, will receive quick consideration and responses.

Responsibilities:

1. Claims Management:
   • Prepare, review, and submit clean claims to insurance payers in a timely manner.
   • Follow up on unpaid or denied claims, ensuring resolution and timely reimbursement.
   • Review and analyze Explanation of Benefits (EOBs) for accuracy and compliance.
2. Accounts Receivable Oversight:
   • Manage accounts receivable balances and maintain accurate records of all collection activities.
   • Reconcile accounts, identify discrepancies, and take appropriate action to resolve them.
   • Contact insurance carriers and patients to secure payment and address billing inquiries.
3. Denial Resolution:
   • Investigate and resolve claim denials or rejections by submitting appeals or corrections.
   • Communicate with insurance payers to address discrepancies and expedite resolutions.
4. Patient Billing:
   • Respond to patient inquiries regarding billing statements, payments, and account balances.
   • Set up payment plans and ensure proper documentation of patient payment arrangements.
5. Compliance and Documentation:
   • Ensure compliance with federal, state, and payer-specific billing regulations, including HIPAA.
   • Maintain detailed and accurate documentation of billing and collection activities.

Qualifications

Qualifications:

• High school diploma or equivalent
• Minimum of 5 years of experience in medical billing, collections, or revenue cycle management.
• Proficiency in medical billing software and familiarity with CPT, ICD-10, and HCPCS coding.
• Strong knowledge of payer regulations, including Medicare, Medicaid, and commercial insurance.
• Exceptional attention to detail and organizational skills.
• Excellent written and verbal communication abilities.
• Strong analytical and problem-solving capabilities.

Working Conditions:

• This position typically operates in a professional office environment. Hybrid or remote work arrangements may be available, depending on organizational policies.