Billing Support Specialist

About the role

Surgical Information Systems (SIS) is seeking a remote Billing Specialist to join our dynamic team. This position is ideal for someone who enjoys working in an ASC or hospital setting and is passionate about providing exceptional patient care through efficient billing processes.

Responsibilities

• Maintain site-specific information for assigned clients.
• Verify the correct contract rate is applied to billing.
• Communicate with and provide documentation to coding and billing departments, including operative notes, implant logs, and pathology reports.
• Coordinate document management between the coding team, billing team, and client to support effective claim billing.
• Provide feedback, guidance, and training support to billers to correct and prevent charge posting errors.
• Monitor the quality of charge entry and claim submission.
• Ensure timely filing of claims via electronic or paper submission.
• Resolve and reconcile submissions, rejections, and edits daily.
• Maintain a clear understanding of the insurance collection process.
• Solve problems associated with assigned tasks.
• Enter charge corrections provided by AR Specialists and rebill payers as needed.
• Correct and resend rejected claims.
• Generate end-of-month unbilled reporting.
• Apply familiarity with CPT codes, ICD codes, and modifiers.
• Calculate pricing for implants and supplies accurately based on site specifics.
• Communicate professionally with internal and/or external clients.
• Pull case documents for audits as needed.
• Post for clients with offshore restrictions as needed.
• Perform other assigned duties.

Requirements

• Knowledge of medical billing and insurance guidelines.
• Proven experience working payer rejections at the time of billing, including but not limited to commercial, government, out-of-network, workers’ compensation, and auto-vehicle claims.
• Knowledge of computers and Windows-driven software, including Microsoft Word, Excel, and Outlook.
• Excellent command of written and spoken English.
• Cooperative attitude when working with co-employees, management, patients, and outside contacts.
• Able to promote a favorable company image with patients, insurance companies, and the general public.
• Strong attention to detail and speed while working within tight deadlines.
• Exceptional ability to follow oral and written instructions.
• High degree of flexibility and professionalism.

Specific Knowledge & Skills Required

• Experience working in an ancillary or Ambulatory Surgery Center (ASC) environment.
• Working knowledge of IPAs and health plans.
• Comfortable with electronic and manual payer follow-up.
• Able to quickly identify trends and escalate as appropriate.
• Ability to read, analyze, and interpret insurance plans, financial reports, and legal documents.

Benefits

• Benefit package including Medical, Vision, Dental, Short Term Disability, Long Term Disability, and Life Insurance.
• Vacation/Sick time.
• 401(k) retirement plan with company match.
• Paid Holidays.
• SIS Cares Day.
• Hybrid or Remote environment depending on the role.

Qualifications

• High school diploma or equivalent.
• Highly organized and detail-oriented.
• Proficient in Microsoft Office Suite.
• Strong communication skills.
• Ability to work independently and manage multiple tasks simultaneously.

Skills

• Medical billing and insurance guidelines.
• Computer proficiency (Windows, MS Office).
• Attention to detail.
• Problem-solving skills.
• Communication skills.

Benefits

• Medical, Vision, Dental, Short Term Disability, Long Term Disability, and Life Insurance.
• Vacation/Sick time.
• 401(k) retirement plan with company match.
• Paid Holidays.
• SIS Cares Day.
• Hybrid or Remote environment depending on the role.