Medical Billing and Accounts Receivable Specialist

Summary/Objective

Responsible for accurately processing patient billing, managing insurance claims, and ensuring timely reimbursement.

Essential Functions

• Verifies insurance benefits and confirms patient eligibility
• Obtains prior authorization for services as required
• Reviews clinician-entered charges for accuracy before generating claims
• Prepares and submits claim files
• Posts insurance and client payments accurately and in a timely manner
• Analyzes and addresses ERA/EOB denials by taking appropriate corrective action
• Manages accounts receivable and actively pursues outstanding balances
• Oversees client collections to ensure timely payment
• Handles insurance appeals for denied or underpaid claims
• Stays informed and compliant with payor reimbursement policies, procedures, and guidelines
• Maintains contracted fee schedules to ensure accurate expected payment
• Foster positive communication and relationships with patients, clinicians, physicians, third-party payors, and other Boundless staff to ensure exceptional customer service
• Adheres to company policies and procedures in addition to regulations, laws, and other requirements from applicable governing bodies, certification, licensure, and/or accreditation entities, etc.

Other Responsibilities

• Other duties as assigned

Supervisory Duties

This position has no supervisory responsibilities.

Education, Skills, Experience and Requirements

• High school diploma required; college coursework a plus
• Preferred 1-3 years’ experience in medical billing and collections, as well as insurance verification
• Proficient in Microsoft 365
• Medical Coding Certification (Preferred)
• Driver’s license and insurable driving record, if applicable

Competencies and Attributes

• Oral and written communication
• Professionalism
• Organizational skills
• Ability to stay focused
• Ability to prioritize multiple tasks
• Computer skills
• Professional phone etiquette

Physical Demands/% of time

• Lifting and carrying up to 20lbs -
• Standing and/or walking -
• Near visual acuity - >75%
• Use of electronics (i.e. computer, tablet) - >75%
• Manual dexterity - >75%
• Use of office equipment (i.e. copier/scanner) - >75%
• Sitting - >75%
• Verbal communication - >75%

Work Hours

Typically Monday through Friday from 8 am to 4:30 pm. This position works remotely.

Travel Requirements

Minimul travel is primarily local during the business day.