Billing & Collections Specialist

Billing And Collections Specialist

As a key member of the Revenue Cycle Management Team, you will play an integral part in helping Enovis drive the medical technology industry forward through transforming patient care and creating better patient outcomes.

Role Summary:

The Billing & Collections Specialist performs a variety of tasks associated with the Billing and Collections of open Accounts Receivable and is responsible for providing quality customer service while collecting on assigned outstanding, aged account balances. This role manages high-risk or escalated accounts, identifies denial and process trends, partners cross-functionally to drive improvements, and serves as a resource to team members to ensure timely collections, reduced aging, and exceptional service to internal and external stakeholders.

Key Responsibilities:

• Prepares, edits, and submits account billing in a timely manner and in accordance with customer contract and payer rules and regulations.
• Demonstrates exceptional service and integrity related to customer accounts through accurate, timely, relevant, and quality work efforts of all Accounts Receivable or assigned tasks.
• Review claims with outstanding balances and identify actions to successfully collect revenues.
• Performs collections for Revenue Cycle Management Department related to cash collections, aged accounts receivables, and denials.
• Follows up with insurers and patients to collect outstanding balances while providing exceptional customer service focused on building enduring business relationships.
• Posts all insurance denials in a timely and accurate manner.
• Collaborates with offshore India team to ensure appropriate audits are taking place and that the Collections Team is appropriately processing denied claims.
• Works to minimize third party payor denials by identifying trends in claim denials, partnering with various cross functional departments.
• Identifies reasons for denials, takes required corrective action, and takes ownership of claims through timely and successful collection.
• Identifies root causes for initial denials and gaps associated with existing workflows.
• Proactively researches and understands payor issues, troubleshooting and resolving issues that impact revenue.
• Provides ongoing trend analysis to identify reasons for denials and apply corrective actions steps to prevent impact to cash flow.
• Communicates analysis to other RCM team members in an effort to increase denial prevention.
• Researches and processes charge revisions, corrections, adjustments, and/or discounts associated with disputes.
• Responsible for telephone and/or written correspondence with insurance companies for claims follow up.
• Documents case activity, communications, and correspondence in Company database to ensure completeness and accuracy of account activity and actions taken to resolve outstanding claims issues.
• Schedules follow-up communications in required intervals.
• Assists with resubmission and review of invoices for aged accounts.

Minimum Basic Qualifications:

• Minimum of 5 years of experience medical billing and collections required.
• Demonstrated experience leading teams required.
• Proficiency in Microsoft Office applications required.
• Knowledge of billing and collections regulations required.
• Experience in a healthcare environment required.
• Knowledge of insurance contract practices, third-party billing and billing to private clients required.
• Demonstrated customer service expertise.
• High School Diploma

Work Environment | Physical Demands:

• Typical office environment.
• Physical Demands: May occasionally lift up to 10 pounds. Routinely uses standard office equipment such as computers, keyboard, phone, print. Required to talk and hear. Must be able to sit and stand for extended periods of time and use hands and fingers to handle or feel, and to manipulate keys on a keyboard and operate portable input devices (e.g., smart phone, mouse). May occasionally reach with hands and arms. Must have the ability to look at a computer screen for extended periods of time.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Desired Characteristics:

• Experience using Dataworks, Computers Unlimited TIMS, or similar third-party billing software strongly preferred

Currently, Enovis does not provide sponsorship for employment visas (e.g., H-1B) and will not offer such sponsorship in the future. Applicants must already have full-time work authorization in the United States, both now and in the future, without requiring sponsorship.

Join us in creating better together.

EQUAL EMPLOYMENT OPPORTUNITY Enovis provides equal employment opportunities based on merit, experience, and other work-related criteria without regard to race, color, ethnicity, religion, national origin, sex, age, pregnancy, disability, veteran status, or any other status protected by applicable law. We also strive to provide reasonable accommodation to employees' beliefs and practices that do not conflict with Enovis policies and applicable law. We value the unique contributions that every employee brings to their role with Enovis.