Billing & Collections Specialist

Billing And Collections Specialist

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 the Revenue Cycle Management Department related to cash collections, aged accounts receivable, and denials.
• Follows up with insurers and patients to collect outstanding balances while providing exceptional customer service focused on building enduring business relationships.
• Post all insurance denials in a timely and accurate manner.
• Reviews and prepares audit documentation and submits within a timely manner to the appropriate auditing entity.
• Identifies reasons for denials, takes required corrective action, and takes ownership of claims through timely and successful collection.
• 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 the 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.
• Maintains professional and technical knowledge by staying current on relevant products, health insurance plans, policies, and procedures.
• Leverages medical billing expertise to provide input on training content, knowledge transfer programs, policies, and procedures in order to improve efficiency and effectiveness of the RCM Team.

Minimum Basic Qualifications:

• High School Diploma or GED required.
• Minimum of 2 years of experience medical billing and collections required.
• Proficiency in Microsoft Office applications required.
• Knowledge of billing and collections regulations strongly preferred.
• Experience in a healthcare environment strongly preferred.
• Knowledge of insurance contract practices, third-party billing and billing to private clients strongly preferred.
• Experience using Dataworks, Computers Unlimited TIMS, or similar third-party billing software strongly preferred.

Travel

• This position does not require travel.

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.

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