Medical Biller/Collections Specialist

Responsibilities

• Manage assigned patient accounts receivable from claim submission through final payment.
• Follow up on outstanding insurance claims, denials, and underpayments with commercial insurance carriers, Medicare, Medicaid, and Medicare Advantage plans.
• Research and resolve billing discrepancies, payment variances, and payer issues.
• Prepare and submit appeals, reconsiderations, corrected claims, and supporting documentation.
• Verify insurance eligibility, effective dates, referrals, and prior authorizations as needed.
• Perform cash posting and payment reconciliation while ensuring accurate account balances.
• Assist with monthly billing, primary and secondary claim processing, and self-pay balance billing.
• Monitor assigned aging accounts and prioritize follow-up activities to maximize collections.
• Maintain accurate documentation of all payer communications and account activity.
• Collaborate with internal staff to obtain documentation necessary for claim resolution.
• Identify reimbursement trends and recommend process improvements.
• Perform additional billing and revenue cycle duties as assigned.

Qualifications

• High school diploma or equivalent required.
• Minimum of 2-3 years of recent medical billing and accounts receivable experience.
• Strong understanding of insurance benefits, primary and secondary billing, and insurance follow-up.
• Experience with appeals, claim corrections, collections, and authorization processes preferred.

Essential Duties & Responsibilities

• Manage assigned patient accounts receivable from claim submission through final payment.
• Follow up on outstanding insurance claims, denials, and underpayments with commercial insurance carriers, Medicare, Medicaid, and Medicare Advantage plans.
• Research and resolve billing discrepancies, payment variances, and payer issues.
• Prepare and submit appeals, reconsiderations, corrected claims, and supporting documentation.
• Verify insurance eligibility, effective dates, referrals, and prior authorizations as needed.
• Perform cash posting and payment reconciliation while ensuring accurate account balances.
• Assist with monthly billing, primary and secondary claim processing, and self-pay balance billing.
• Monitor assigned aging accounts and prioritize follow-up activities to maximize collections.
• Maintain accurate documentation of all payer communications and account activity.
• Collaborate with internal staff to obtain documentation necessary for claim resolution.
• Identify reimbursement trends and recommend process improvements.
• Perform additional billing and revenue cycle duties as assigned.

Required Skills

• Dialysis billing experience is a plus but not required.
• Proven success working insurance aging and denied claims.
• Strong analytical and problem-solving abilities.
• Excellent verbal and written communication skills.
• Ability to work independently while managing assigned accounts.
• Highly organized with exceptional attention to detail.
• Proficiency in Microsoft Office Suite and medical billing software.
• Ability to prioritize workload and meet deadlines in a fast-paced environment.
• Customer service mindset with a professional and positive attitude.

Pay

Competitive salary commensurate with experience (Hourly Range: $25 to $35 depending on skill).

Benefits

• A company funded Pension Plan;
• Voluntary self-directed 403-B and Roth plans available;
• Group Health Insurance substantially covered by employer;
• Optional Dental and Vision;
• Company provided Basic Life and Short-Term Disability plan;
• Variety of other voluntary benefits for qualified employees;
• Medical and Child Care Flexible Spending Accounts;
• Tuition Reimbursement;
• Free Gated/Secure Parking;
• Full Time Work Week is 36 hours.