Billing Specialist

Job Description

Job Description

Dent Neurologic Institute is committed to excellence in all we do.  Our culture is built on 4 key pillars: respect, quality, productivity, and well-being.  By remaining dedicated to these values and the overall mission, we are dedicated to making a difference for both patients and colleagues.   When you join the Dent team, you can take advantage of a variety of benefits:

• Work-Life Balance (no overnight shifts)
• Medical, Dental & Vision Plans
• Life Insurance
• 401(k) Retirement Plan
• Critical Illness, Accident, & Legal Plans
• Wellness Program
• Learning & Development Opportunities
• Paid Time Off
• Paid Holidays 
• Free Onsite Parking at All Locations

Working Schedule:   Full-time,  Monday - Friday, 8:30 am to 5:00 pm

Location: Amherst

Position Summary 

Join our growing team! Under direct supervision, the Medical Billing A/R Specialist plays a key role in driving the success of our revenue cycle by initiating and coordinating all functions related to collecting on medical claims. This is a great opportunity for a motivated, detail-oriented individual looking to build or grow a career in healthcare administration. We are willing to train the right candidate, and prior experience in medical billing, accounts receivable, or healthcare revenue cycle is a plus. 

Responsibilities of Position  

• Perform follow-up and manage denied claims by working assigned insurance denial buckets and follow-up queues. 
• Research and follow up on outstanding receivables via telephone, written correspondence and electronic portals; document all activity including claim status, appeal progress, call reference numbers, and insurance representative details 
• Utilize computer systems and payer websites to access claim status, send inquiries and appeals, insurance procedures, and treatment policies 
• Use all available resources to resolve claims, including documentation, medical records, authorizations, coding manuals, and reference materials 
• Understand payer-specific appeal processes, including when to escalate to formal appeals 
• Analyze denial reasons, prepare and submit effective appeal letters, and ensure proper supporting documentation is included 
• Meet timely filing deadlines for all claims and ensure timely resolutions 
• Manage accounts receivable across aging buckets (45, 90, 120+ days) 
• Resolve negative balance claims and process refunds as needed 
• Manage insurance correspondence sent in via mail 
• Ensure strict adherence to organizational billing, refund, and accounts receivable policies 
• Answer patient calls regarding billing questions in a professional and helpful manner 
• Maintain professional, respectful communication with patients, team members, and other departments 
• Maintain strict confidentiality of patient information in accordance with HIPAA regulations 
• Complete duties efficiently as directed by leadership and report errors or issues promptly 
• Perform additional duties as assigned by Billing Manager, Team Lead, Sr. Revenue Cycle Manager, or CFO 
• Posts all charges, including inpatient and outpatient services in accordance with current ICD-9 and CPT coding. 
• Verifies all pending encounters have been addressed and entered accordingly. 
• Registers patients in billing system when necessary (i.e. in-patient). 
• Ensures insurance and claim accuracy. 
• Posts all charges, including inpatient and outpatient services in accordance with current ICD-9 and CPT coding. 
• Verifies all pending encounters have been addressed and entered accordingly. 
• Registers patients in billing system when necessary (i.e. in-patient). 
• Ensures insurance and claim accuracy. 

Skills & Experience Necessary 

• Basic understanding of insurance plans, contracts, and policies preferred; willing to train the right candidate 
• Familiarity with interpreting EOBs, including copays, coinsurance, deductibles, and retractions is a plus 
• Knowledge of billing processes such as claims management, charge entry and payment posting preferred but not required 
• Exposure to insurance verification processes, referrals, and authorization requirements is a plus 
• Familiarity with medical terminology is a plus 
• Strong sense of urgency and ability to meet deadlines 
• Ability to prioritize and manage multiple tasks in a fast paced environment 
• Strong customer service, organizational, and problem-solving skills 
• General office skills, including typing and data entry 
• Working knowledge of Microsoft Office (Excel, Word) 
• Familiarity with general office equipment (multi-line phone, copier, fax, etc.) 
• Effective communication and interpersonal skills 
• Willingness to learn and be trained in medical billing and accounts receivable processes

Required Education:

• High school diploma with a minimum of 2 years of Medical Billing experience

Preferred Education:

• Associates Degree in Medical Billing and Reimbursement with a minimum of 1 years of Medical Billing experience

Working Conditions:

• Normal working environment, typical of most office settings 
• Minimal physical effort, requires some lifting of files, usually not in excess of 15 pounds. 
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions 

  Compensation:

• Most candidates will start within the first quartile of the pay range
• Rates are commensurate with experience

EEO Statement 

Dent Neurologic Institute offers an inclusive work environment built on kindness and respect for all.  Dent provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws as the basis for an employment decision.  All qualified individuals are encouraged to apply and will receive consideration.