Billing Support Specialist

Role Description

• Maintain site-specific information for assigned clients.
• Verify that the correct contract rate is applied to billing.
• Work billing rejections in clearinghouses, including Waystar.
• Communicate with and provide documentation to coding and billing departments, including operative notes, implant logs, and pathology reports.
• Coordinate document management between the coding team, billing team, and client to support effective claim billing.
• Provide feedback, guidance, and training support to billers to correct and prevent charge posting errors.
• Monitor the quality of charge entry and claim submission.
• Ensure timely filing of claims via electronic or paper submission.
• Resolve and reconcile submissions, rejections, and edits daily.
• Maintain a clear understanding of the insurance collection process.
• Solve problems associated with assigned tasks.
• Enter charge corrections provided by AR Specialists and rebill payers as needed.
• Correct and resend rejected claims.
• Generate end-of-month unbilled reporting.
• Apply familiarity with CPT codes, ICD codes, and modifiers.
• Calculate pricing for implants and supplies accurately based on site specifics.
• Communicate professionally with internal and/or external clients.
• Pull case documents for audits as needed.
• Post for clients with offshore restrictions as needed.
• Perform other assigned duties.

Qualifications

• Knowledge of medical billing and insurance guidelines is required.
• Proven experience working payer rejections at the time of billing, including but not limited to commercial, government, out-of-network, workers’ compensation, and auto-vehicle claims.
• Knowledge of computers and Windows-driven software, including Microsoft Word, Excel, and Outlook.
• Excellent command of written and spoken English.
• Cooperative attitude when working with co-employees, management, patients, and outside contacts.
• Ability to promote a favorable company image with patients, insurance companies, and the general public.
• Strong attention to detail and speed while working within tight deadlines.
• Exceptional ability to follow oral and written instructions.
• High degree of flexibility and professionalism.
• Experience working in an ancillary or Ambulatory Surgery Center (ASC) environment.
• Working knowledge of IPAs and health plans is required.
• Comfortable with electronic and manual payer follow-up.
• Able to quickly identify trends and escalate as appropriate.
• Ability to read, analyze, and interpret insurance plans, financial reports, and legal documents.

Benefits

• Benefit package including Medical, Vision, Dental, Short Term Disability, Long Term Disability, and Life Insurance.
• Vacation/Sick time.
• 401(k) retirement plan with company match.
• Paid Holidays.
• SIS Cares Day.
• Hybrid or Remote environment depending on the role.