Billing Specialist II

About the role

The Billing Specialist II at Rebis Health is responsible for converting aged receivables to cash, resolving complex denials, and raising the standard for how claims are handled. This role is crucial for funding clinical programs that help patients sleep, breathe, and heal.

Responsibilities

• Aged A/R converted to cash: Ensure that assigned aging buckets are worked at ≥1.5 touches per account per week, reducing the 90+ day bucket by ≥60% by the end of each month.
• Complex denials resolved: Handle the harder denial mix, including prior auth disputes, complex payer reversals, and claims requiring clinical context and appeal strategy.
• Appeals submitted right and on time: Ensure that ≥95% of appeal packets are submitted within 5 business days of readiness, with ≤2% incomplete packet rate.
• Denial trends identified and escalated: Document and analyze recurring patterns, escalating them with evidence within 5 business days to prevent compounding issues.
• Level I teammates doing better work: Complete a QA review and documented coaching session with at least one Level I team member each month, sharing knowledge and improving performance.
• Patient financial conversations: Maintain ≥90% QA scores for clarity, empathy, and accuracy in handling payment plans, disputes, or high-balance accounts.

Requirements

• 2+ years of Medical Billing experience with a demonstrable track record in denial management and A/R recovery.
• Experience building and submitting appeal packets that win.
• Working knowledge of payer-specific billing rules and prior authorization processes.
• Strong experience in Athenahealth and/or Brightree, a comparable EHR/PMS preferred.
• Ability to explain complex billing situations clearly and efficiently.

Qualifications

• Experience in Sleep Medicine, DME, Neurology, or specialty outpatient billing.
• Track record of formally or informally mentoring a junior biller.
• Experience tracking and analyzing appeal win rates (or willingness to do so).

Skills

• Analytical thinking to identify patterns and improve processes.
• Effective communication skills to handle patient interactions with clarity and empathy.
• Attention to detail for accurate and efficient claim processing.
• Ability to manage multiple tasks and prioritize responsibilities effectively.

Benefits

• 401(k)
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Unlimited PTO plus Paid Federal Holidays
• Complimentary Rebis Health Care Access
• Hybrid Work Eligibility