Biller/Collections Specialist

Job Description

Job Description

The Carpenter Health Network – Restorative’s Post Acute Care Division is seeking a Full-Time Biller/Collection Specialist!

We offer you: Excellent Pay, Complete Benefits Package including: Health, Dental, Vision & Life Insurance, Paid Time Off (PTO), 401-K, and Remarkable Career Advancement Opportunities.

Essential duties and responsibilities include:

• Prepare, review, and submit claims accurately and timely.
• Monitor claim status through payer portals, clearinghouses, and internal RCM systems.
• Investigate, resolve claim rejections, denials, underpayments and payment variances.
• Submit corrected claims, appeals, reconsiderations, as necessary.
• Post payments/collections to accounts.
• Analyze remittance advices and explanation of benefits to identify reimbursement discrepancies.
• Perform account receivable follow-up activities to secure payment on outstanding accounts, including patient statements.
• Review accounts for appropriate adjustments, write-offs, and contractual allowances.
• Document all account activity thoroughly within the billing/RCM system.
• Maintain compliance with Medicare, Medicaid, and commercial payer billing regulations.

Requirements:

• Minimum 2-year billing and collection experience, required.
• Strong understanding of Institutional, Professional, and OPPS reimbursement methodologies.
• Demonstrated knowledge of Medicare, Medicaid, and other payor guidelines and criteria for reimbursement.
• Familiarity of UB-04 and CMS-1500 claim requirements.
• Ability to interpret remittance advises, contracts, and payer correspondence.
• Proficiency with clearinghouses and payor portals.
• Strong organizational skills with the ability to manage high account AR volumes.
• Excellent communication and customer service skills when responding to questions and other inquiries from internal and external customers.
• Strong computer and software skills.

Exceptional Care. Exceptional People.

Only candidates with appropriate experience will be considered. All others need not apply.

All inquiries will be kept confidential

EOE