Billing & Reconciliation Specialist

Description We’re building ‘the’ Teaching Hospital for pediatric therapy — a category of one by driving excellence in outcomes, developing clinicians, building payer trust, and embedding systems across what we do. As a member of the Billing & Payment Posting Team, you will split responsibilities between billing services and posting/reconciling payments. While the typical workload will be evenly divided (approximately 20 hours each week per function), there may be weeks where the balance shifts depending on department needs. Success in this role is measured by your ability to bill claims accurately and on time, and to ensure payments are posted and reconciled promptly. Your work supports cash flow, enables accurate financial reporting, and helps sustain continuity of care for families. Key Responsibilities: Billing Prepare, review, and submit claims accurately in compliance with payer rules, coding standards, and internal policies. Ensure services are billed within established timelines, targeting an average of 5 days from the date of service. Monitor daily billing queues and prioritize to ensure 75% of monthly services are billed within the same month and 90% by the first run of the following month. Re-bill claims promptly when notified of insurance changes, meeting turnaround requirements. Monitor clearinghouse rejections, correct errors, and resubmit to minimize delays. Collaborate with Credentialing, Eligibility, Authorization, and AR teams to resolve front‑end issues contributing to billing delays or denials. Payment Posting & Reconciliation Post payments from ERAs/EOBs into the billing system within established turnaround times, ensuring accuracy. Reconcile daily cash receipts across payers, bank deposits, and system records. Identify, log, and categorize all denials during posting, routing to AR for follow‑up. Monitor unapplied cash and resolve posting variances promptly. Collaborate with AR, Billing, and QA teams to address recurring issues and prevent errors. Maintain detailed documentation of payment posting and reconciliation activities for audit readiness. Shared Responsibilities Maintain accurate documentation across billing and reconciliation functions. Support leadership by providing data and insights on billing and payment trends. Actively identify opportunities to reduce recurring errors and contribute to root cause solutions. Uphold HIPAA compliance and confidentiality standards in all work. Contribute to process improvement initiatives to streamline billing and payment workflows. Performance Metrics Monthly Cash Collections Target: =95% of target met, with performance encouraged to exceed 100%. Average Days to Bill: 5 days or fewer, with 75% of services billed within the same month. First Pass Acceptance Rate (Clean Claims): =90%. Average Days to Pay (Clean Claims): Fewer than 20 days. Payment Posting Timeliness: =95% of payments posted within 48 hours of receipt. Payment Posting Accuracy: =98%. Denial Management: 100% of assigned denials logged and routed for follow‑up. Error Prevention: Active participation in root cause identification and correction across the RCM team. Requirements Desired Qualifications and Experience Associate or bachelor’s degree in healthcare administration, business, or accounting preferred. Minimum 2 years of experience in healthcare billing, payment posting, reconciliation, or revenue cycle operations (ABA experience preferred). Familiarity with payer billing requirements, CPT/HCPCS and modifier codes, ERA/EOB formats, and denial codes. Experience with RCM systems and clearinghouse platforms; Central Reach experience highly preferred. Strong organizational skills, attention to detail, and ability to manage multiple priorities. Strong problem‑solving skills, persistence, and resilience in a fast‑paced environment. Effective communication and interpersonal skills with a collaborative mindset. Proficiency in Microsoft Office Suite, particularly Excel. Essential Job Functions Must have manual dexterity to perform specific computer and electronic device functions Must have visual acuity to read and comprehend written communication though computer, electronic devices, and paper means. Must be able to maintain prolonged periods of working on a computer while sitting at a desk and attending virtual meetings Job Type: Non‑Exempt, Full‑Time Pay is competitive and based on candidate qualifications and experience. Full‑time employees will be offered our comprehensive benefits including Paid Time Off, 401k, insurance (health, dental, and vision), and the option of Short and Long‑Term disability insurance. Our Story: A Legacy of Progress, Fueled by Play In 2006, Bierman Autism Centers began with a simple dream: to empower children with autism to thrive. We believed in the power of letting kids be kids and initially offered in‑home care to foster a comforting and familiar environment. We were driven by three core beliefs: achieving remarkable progress with children, creating a great team that enjoys working together, and building a workplace that fosters internal career paths and growth for our team members. Our dedication to progress led us to a pivotal moment. Recognizing the potential of center‑based care, we opened our first center in Indiana in 2010. This wasn’t just about location; it shifted our philosophy. Centers allowed us to create consistent, nurturing environments tailored to each child’s needs. This shift became the cornerstone of our success. Today, Bierman Autism Centers are beacons of innovative care across Arizona, Indiana, Massachusetts, New Jersey, North Carolina, Ohio, and Rhode Island. We offer ABA therapy, Speech Therapy, Occupational Therapy and Diagnostic Services within center‑based settings designed for the comprehensive development of our children. Bierman Autism Centers values diversity in the workplace. The company provides equal opportunity for employment and promotion to all qualified employees and applicants on the basis of experience, training, education, and ability to do the available work without regard to race, religion, color, age, sex/gender, sexual orientation, national origin, gender identity, disability, marital status, veteran status, genetic information, ancestry, or any other status protected by law. Furthermore, Bierman Autism Centers is committed to providing an equal opportunity workplace that is free of discrimination and harassment based on national origin, race, color, religion, gender, ancestry, age, sexual orientation, gender identity, disability, marital status, veteran status, genetic information, or any other status protected by law. As an equal opportunity employer, Bierman Autism Centers does not discriminate against qualified individuals with disabilities. If you require a reasonable accommodation as a candidate for employment, please inform a member of the Talent Acquisition team. #J-18808-Ljbffr