Remote Billing Specialist

Billing Specialist

The Billing Specialist supports Revenue Operations by managing medical billing processes, including coding, payment posting, accounts receivable aging, and denial follow-up. This role ensures accurate and timely processing of claims and payments across Electronic Health Records (EHR) and Practice Management Systems (PMS).

Responsibilities:

• Billing and management of claims for multiple programs and payers to achieve maximum reimbursement
• Maintain working knowledge of multi-state payer rules, including Medicaid/MCOs, commercial insurance, third-party liability, state contracts, grants, and inter-organizational billing requirements
• Ensure claims are submitted timely and in compliance with payer requirements, reviews remittance advice to identify underpayments or discrepancies
• Reduce rejections and denials by scrubbing claims for timely and accurate submission
• Manages the resolution of insurance claim denials through detailed review, correction, and resubmission to optimize revenue recovery
• Collaborates with internal teams to resolve billing issues and improve workflows
• Manages aging accounts by contacting commercial payers and state programs to ensure timely and accurate payment
• Monitors aging reports to prioritize follow-up efforts
• Identifies, verifies, and submits claims to secondary and tertiary insurance carriers to maximize reimbursement
• Accurately posts insurance and patient payments into Practice Management Systems (PMS)
• Prepares and maintains Excel worksheets, tracking tools, and ad hoc reports to support revenue cycle operations
• Prepares, or assists in the preparation of, financial reports, analyses, and special projects as needed
• Conducts follow-up with payers to resolve denials, rejections, and unpaid claims
• Maintain and manage Billing workflows across assigned programs to ensure efficient and consistent operations
• Reviews accounts to determine if adjustments are necessary

Minimum Experience & Requirements:

• High School diploma or equivalent
• Minimum of two years of billing experience in a healthcare setting, behavioral health preferred
• Must be 21 years of age
• Must have a valid Driver's License
• Must pass a drug screen, MVR, and Child Abuse and Neglect Central Registry clearance check
• Lifting Requirements of 30-50 lbs