Posted 9 days ago

Billing Specialist

AnkenyHybrid

AI Summary

Performs financial tasks in support of the Billing/Revenue Cycle Department, including creating billing reports, submitting claims, reconciling agency accounts, resolving denials, and mentoring junior staff.

About this role

The Billing Specialist is responsible for performing specified financial tasks in support of the day-to-day operations of the Billing/Revenue Cycle Department. We’re looking for someone with a strong internal drive to solve problems, drive collections, is a team player, and ensure every claim is handled with care and urgency.

Following training, this will be a hybrid position offering the opportunity to work 3 days in the office and 2 days remotely each week.

Position Responsibilities may include, but not limited to

Create billing reports of assigned agencies

Submit accounts receivable claims and/or invoices for weekly/monthly billing of assigned agencies

Reconciliation of assigned state or local agencies

Research and resubmit of billings to assigned agencies

Review quality assurance of all referrals or updated clients from assigned state or local agencies

Make outbound & inbound calls, emails to assigned state or local agencies with the purpose of securing correct information regarding new referrals, updated clients, and billings

Responsible for executing complex billing tasks, mentoring junior staff, and leading cross-functional initiatives

Reduce payment agency backlog

Perform in-depth audits of project data to identify and resolve billing discrepancies

Demonstrate successful performance through accuracy, timeliness, and customer satisfaction metrics

Utilize advanced Excel functions (e.g., VLOOKUP) and reporting tools in CRM and SharePoint

Manage complex billing scenarios including denials, rejections, and aging accounts

Collaborate with Posting teams to resolve discrepancies and support month-end close

Prepare and submit electronic claims, paper claims, and invoices (CMS-1500, UBs, invoices, and payer portals, etc.)

Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans

Ensure accurate and compliant billing, following specific regulations of multi-state Medicaid and MCO's, Medicare Advantage, and Older Americans Act programs

Responsible for ensuring aged outstanding balances of assigned payers is kept within department standards

Participate in process improvement initiatives. Collaborate across teams to resolve issues, claims denials, and aging

Other tasks as assigned, including but not limited to, assisting with projects that impact collections or write offs

Required Skills and Experience

High School Diploma or GED

2+ years of work-related experience in healthcare related field, ie, healthcare billing institutional and professional claims, patient registration, and/or patient access

Intermediate level Excel skills

Strong oral and written communication skills

Ability to multi-task, set priorities, and pays close attention to detail

Strong ability to work with team members across multiple departments

Ability to work unsupervised with strong critical thinking and problem-solving skills

Experience with Waystar, CRM, D365, and/or electronic health record platforms

Must have a wired internet connection using an ethernet port. Broadband internet wired to the home is required - Cable Modem/service or Fiber Optic. No Satellite, 4/5G, or DSL circuits

Must have a quiet workspace that is free from distraction

Preferred Skills and Experience

Bachelor's degree in healthcare administration, medical administrative assistance, or healthcare finance

Previous experience with electronic claims, such as electronic 835/837 claim and remit files, Zirmed, and/or secure payer web portals

AAHAM and/or HFMA certification

Knowledge of CMS regulation and strong familiarity with healthcare billing standards and compliance

Experience with Waystar, CRM, D365, and/or electronic health record platforms

Physical Requirements

Repetitive motions that include the wrists, hands and/or fingers

Sedentary work that primarily involves sitting, remaining in a stationary position for prolonged periods

Visual perception to perform job including peripheral vision, depth perception, and the ability to adjust focus

Skills

AAHAMCMS-1500CRMD365Electronic 835/837 Claim FilesElectronic Health Record PlatformsExcelHFMAMCOMedicaidMedicare AdvantageOlder Americans ActPayer PortalsSecure Payer Web PortalsSharePointUBSVLOOKUPWaystarZirmed

Billing Specialist

About this role

Position Responsibilities may include, but not limited to

Required Skills and Experience

Preferred Skills and Experience

Physical Requirements

Skills

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