Facility Billing Specialist

About the Role

This position ensures the accuracy of facility invoicing through internal audit processes, maintains a thorough working knowledge of facility contracts and obligations, and understands correct billing procedures as they pertain to facility responsibility. The role involves billing facilities in accordance with contract terms, monitoring outstanding balances, and proactively following up to secure timely payment on facility accounts.

Responsibilities

• Reviews all facility invoices for accuracy against negotiated rates and contract provisions prior to invoicing, ensuring billed amounts, service dates, and volumes reconcile to the underlying contract terms.
• Maintains a working knowledge of each assigned facility contract, including rate schedules, billing frequency, invoicing requirements, payment terms, and any facility-specific billing stipulations or exceptions.
• Applies contract terms correctly when generating invoices and escalates discrepancies between contracted rates and billed amounts for resolution prior to submission.
• Reviews and bills claims that were denied by the primary payer, determining facility responsibility in accordance with contract terms.
• Prepares and sends out monthly facility invoicing in accordance with each contract's billing schedule and required format.
• Regularly reviews the aging report to identify past-due facility accounts, prioritizing follow-up based on balance size, age, and contract payment terms.
• Conducts proactive, ongoing follow-up with facilities on outstanding balances via phone and written correspondence to secure timely payment and resolve billing disputes.
• Documents all collection and follow-up activity on facility accounts, including payment commitments, disputes, and resolution status.
• Identifies accounts with recurring payment delays or disputes and escalates to the Billing Manager.
• Responds to facility inquiries regarding invoices, balances, and contract terms in a timely and professional manner.
• Updates rates and billing parameters in the billing system per contract specifications, ensuring changes are applied accurately and effective as of the correct contract date.
• Adheres to company policies and procedures.
• Performs other duties as assigned.

Skills

• Ability to read, analyze, and interpret facility contracts and insurance plans.
• Intermediate knowledge of Medicare, Medicaid, and insurance benefits.
• Strong understanding of contract-based billing principles, including rate application, billing cycles, and facility payment terms.
• Skilled in reviewing and interpreting aging reports to prioritize collection follow-up and identify at-risk accounts.
• Accurate, high-level data entry skills with a continuous quality focus.
• Excellent phone and customer service skills, including the ability to professionally manage payment follow-up conversations with facility contacts.
• Detail-oriented with excellent organizational and problem-solving skills.
• Proficiency in MS Office and general computer skills, including experience with billing system rate tables and aging/collections reporting tools.

Qualifications

• High School Graduate or equivalent.
• Minimum of 9 months experience in a medical office setting.
• Prior experience with contract-based billing, facility billing, or collections/aging follow-up preferred.

Physical Requirements

• Works around standard office conditions, with repetitive use of a keyboard at a workstation and use of manual dexterity.
• Frequent use of manuals and other resources.
• Works in shared office space and sits for long periods of time.
• Regular attendance is an essential function of the position.