Billing Specialist (REMOTE) - (Texas ONLY)

Billing Specialist (REMOTE) - (Texas ONLY)

Little Spurs Pediatric Urgent Care Centers is seeking an experienced biller to join our dynamic team. Under general direction, the billing specialist will exercise independent judgement while adhering to established policies and procedures, regulations, and best practices.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

• High school diploma or equivalent required; Associates or bachelor's degree in Finance, Accounting, Business Administration, or related field preferred
• 3 + years of billing and coding experience in the healthcare field required; to include urgent care, ABA therapy or similar services
• Must possess in-depth knowledge of medical billing; experience with pediatric billing preferred
• Experience with robust practice management/EMR system, preferably eMDs and Waystar.

Benefits

• Medical, Dental & Vision Benefits available for employee, spouse, and dependents
• Voluntary Short-Term & Long-Term Disability & Voluntary Life Insurance (Employee, Spouse, Children)
• 401k with 4% company match on 5% employee contribution
• Holiday pay (Closed Thanksgiving and Christmas); shorter holiday hours
• 80 hours of PTO accumulated through the year; available for rollover
• More PTO accrued after three and five years of service
• Free in-house medical care for employee and dependent children
• Employee recognition and appreciation programs
• Professional Development Opportunities

Required Skills and Abilities

• Comprehensive knowledge of coding, billing, processes and requirements
• Knowledge of local payers, to include billing and claims resolution processes
• Knowledge in physician practice technology as it relates to creating, transmitting and collecting claims
• Knowledge of physiology, anatomy, neurology and medical terminology.
• Ability to communicate clearly both written and verbally.
• Ability to work independently with detail and accuracy.
• Excellent interpersonal communication skills
• Ability to act with discretion, tact, and professionalism in all situations.
• Ability to work in a remote or hybrid work environment.
• Ability to work well within a team dynamic.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
• Ability to use a fax machine, copier and a scanner
• Must have a passion for Revenue Cycle and a positive mindset
• Bilingual a plus!
• We use E-Verify

Essential Duties and Responsibilities

• Performs all necessary tasks to provide overall direction and support in billing, accounts receivable and related areas.
• Responsible for managing the charge capture, coding, billing and billing edits.
• Responsible for coordinating with providers and Regional Medical Directors to create efficient, accurate templates and automated charging/billing processes
• Analyze trends, impacting charges, coding, and collections and take appropriate action to realign staff and revise policies.
• Analyze billing and claims for accuracy and completeness and submit claims to proper insurance entities and follow up on any issues.
• Ensures that the correct coding and compliance guidelines are being adhered to.
• Maintains systems, policies & procedures to ensure compliance with all contractual obligations of payers.
• Responsible for monitoring reimbursements.
• Responsible for staying familiar with federal and state regulations and company policies.
• Effectively communicates to employees and hold yourself accountable for meeting those same expectations.
• Assists with staff communication providing updates, resolving issues, setting goals and maintaining standards.
• Assists with work allocation and problem resolution.
• Assists with month end reports
• Performs other related duties as assigned.

Your Day to Day

• Performs appropriate billing/payment posting functions as assigned.
• Follows up on unpaid or improperly paid claims as necessary.
• Reviews and monitors select accounts within the accounts receivable system.
• Determines and performs appropriate collection efforts to resolve accounts, to include follow-up online, by phone and written correspondence.
• Effectively applies protocol in company EMR: Invoice Balance Responsibility/Applies Invoice Status correctly.
• Builds claims and applies knowledge of medical terminology, ICD/CPT codes to complete daily
• Corrects denied submission and denied claims in a timely manner and notes invoice accordingly.
• Submits claims electronically and by paper.
• Assist with telephone inquiries and billing questions promptly, with professionalism and courtesy.
• Generates and reviews patient statements effectively and ensures appropriate collection correspondence is sent and documented per protocol.