Biller/Collections Specialist

Essential Duties And Responsibilities

• Prepare, review, and submit claims accurately and timely.
• Monitor claim status through payer portals, clearinghouses, and internal RCM systems.
• Investigate, resolve claim rejections, denials, underpayments and payment variances.
• Submit corrected claims, appeals, reconsiderations, as necessary.
• Post payments/collections to accounts.
• Analyze remittance advices and explanation of benefits to identify reimbursement discrepancies.
• Perform account receivable follow-up activities to secure payment on outstanding accounts, including patient statements.
• Review accounts for appropriate adjustments, write-offs, and contractual allowances.
• Document all account activity thoroughly within the billing/RCM system.
• Maintain compliance with Medicare, Medicaid, and commercial payer billing regulations.

Requirements

• Minimum 2-year billing and collection experience, required.
• Strong understanding of Institutional, Professional, and OPPS reimbursement methodologies.
• Demonstrated knowledge of Medicare, Medicaid, and other payor guidelines and criteria for reimbursement.
• Familiarity of UB-04 and CMS-1500 claim requirements.
• Ability to interpret remittance advises, contracts, and payer correspondence.
• Familiarity with clearinghouses and payor portals.
• Strong organizational skills with the ability to manage high account AR volumes.
• Excellent communication and customer service skills when responding to questions and other inquiries from internal and external customers.
• Strong computer and software skills.

Benefits

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• Paid Time Off (PTO)
• 401-K

Pay

• Commensurate with experience

Schedule

• TBD