Billing/Collections Specialist

Essential Functions

• Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.
• Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.
• Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
• Updates and confirms as necessary to allow processing of claims to insurance plans.
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
• Attaches referrals/authorizations to appointments/charges if available.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.
• Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.
• Identifies and communicates trends and/or potential issues to management team.

Requirements

• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
• Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement.
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
• Obtains and attaches referrals/authorizations to appointments/charges.
• Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding accounts.
• Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.

Qualifications

• High school diploma or equivalent required.
• Bachelor’s degree in healthcare, medical billing, or related field preferred.
• Minimum of 2 years of experience in medical billing and collections.
• Knowledge of medical terminology, coding standards, and insurance billing practices.
• Strong attention to detail and organizational skills.
• Excellent communication and problem-solving abilities.

Skills

• Proficient in medical coding and billing software.
• Ability to manage multiple tasks and prioritize effectively.
• Strong analytical and troubleshooting skills.
• Excellent interpersonal and customer service skills.

Benefits

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan with company match
• Employee Assistance Program that is available 24/7 to provide support
• Paid Time Off
• Paid Holidays
• Mileage reimbursement

Pay

• Competitive salary based on experience and qualifications.

Schedule

• Full-time position.