Medical Billing and Collections Specialist

Shift Schedule: Mon-Fri, 8hrs/day. Start time to be between 6-8 am Pacific time The Medical Billing and Collections Specialist is responsible for the timely and accurate processing of patient accounts receivable billing and collections for a medical client of Aquent. Working under initial close supervision on routine, structured assignments, this role handles simple queries and day-to-day Patient Financial Services (PFS) administrative operations. The ideal candidate will follow accepted institutional practices and escalated complex or non-routine billing issues to senior team members. Key Responsibilities Insurance Follow-Up & Collections : Follow up on unpaid accounts within the patient accounting systems via payer websites or telephone. Review claims for underpayments, research payer contracts/guidelines, resolve payment issues, and process formal insurance appeals. Billing & Claims Editing : Monitor automated billing worklists to review and edit accounts. Resolve claims edits, address electronic payer rejections/denials, and rebill or resend claims as requested by follow-up teams. Cash Posting & Financial Adjustments : Post payments and adjustments accurately within the system. Manage undistributed payment worklists, process refund requests, and transfer payments between professional and hospital billing accounts. Perform or request contractual write-offs and bad debt transfers as appropriate. Data Control & Charge Entry : Input charges manually and resolve charge issues via system worklists. Coordinate with internal clinical departments to research discrepancies and execute charge corrections (including adding diagnoses, reversing charges, combining accounts, or handling monthly clinical lab data entry). Patient Advocacy & Customer Service : Complete and process patient financial charity applications. Review and validate high-dollar self-pay accounts, handle patient billing inquiries or complaints, and maintain exceptional telephone courtesy. Cross-Functional Communication : Maintain professional verbal and written communication with PFS staff, medical facility personnel, insurance payers, physicians, and patients regarding billing and services rendered. Productivity & Metrics : Meet weekly individual productivity goals and strict accuracy standards while following planned priorities set by management. Qualifications Education High School diploma or GED equivalent required. Required Knowledge, Skills, and Abilities Systems & Software : Hands‑on knowledge of core computer applications and basic office software, specifically Microsoft Office (Outlook, Excel). Foundational knowledge of a major medical accounts receivable system (such as Epic) is required. Industry Core Competencies : Strong familiarity with insurance and medical terminology, medical reimbursement policies, and procedures. Payer Knowledge : Working knowledge of one or more major payer types, including Medicare, Medi‑Cal/Medicaid, Worker's Compensation, or Managed Care (HMO, PPO, POS). Operational Capabilities : Strong written and verbal communication skills, data formatting/record‑keeping skills, and basic mathematics proficiency. Execution & Compliance : Ability to prioritize routine tasks to meet strict deadlines, maintain strict confidentiality of sensitive patient information, and accurately interpret written institutional policies. Customer Service : Demonstrated adherence to the principles and practices of professional customer service and telephone etiquette. Preferred Skills (Nice-to-Have) Direct experience with Epic charge entry and workqueue (WQ) navigation. High proficiency with rapid ten‑key data entry. The target hiring compensation range for this role is $33 to $35.96 an hour. Compensation is based on several factors including, but not limited to education, relevant work experience, relevant certifications, and location. Aquent is an equal‑opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. #J-18808-Ljbffr