Regional Billing Specialist

General PurposeThe Regional Billing Specialist is responsible for ensuring the accuracy, integrity, and efficiency of accountsreceivable processes across the designated region. This role serves as a technical expert and oversightmechanism to maximize collections and minimize aging through proactive claims management and adherenceto payer regulations.Essential DutiesClaims Management & Billing AccuracyTrial Claims: Generate trial claims regularly to identify and resolve billing errors prior to final submission.Billing Cycle Oversight: Ensure all prior-month claims are billed immediately following the Triple Check date.Unbilled Claims Management: Maintain a cumulative list of all unbilled claims; provide daily updates and documentation until all prior-month claims are successfully released.Clearinghouse Maintenance: Review Waystar for rejected claims daily. Ensure all rejections are corrected and resubmitted within one business day.Payer Compliance & Revenue IntegrityContractual Expertise: Maintain comprehensive working knowledge of payer contracts and rules; ensure all billing aligns strictly with specific contract provisions.Payer Sequencing: Review Payer Setup Information reports regularly to identify inaccuracies. Execute corrections or direct Business Office Managers to resolve errors via the collection note process.Denial Management: Monitor insurance portals for status updates and denials. Execute immediate corrections or submit formal appeals as appropriate to secure payment.Collections & Cash ApplicationCollection Module Oversight: Monitor the PointClickCare Upcoming Activity Tab. Review outstandingaccounts, initiate new activities, and provide direct feedback/notes to BOMs within the module.Account Documentation: Ensure detailed, professional notes are added to all accounts worked withinPCC to maintain a clear audit trail.Cash Posting & Reconciliation: Post all payer-appropriate cash to PCC daily. Perform regularreconciliations between bank deposits and PCC postings to ensure financial data integrity.Reporting & AnalysisTrend Identification: Analyze accounts receivable aging reports to identify negative trends or systemic issues.Management Reporting: Keep executive leadership informed by providing concise summaries and actionable insights regarding the region's financial health.Supervisory RequirementsThis role has no supervisory requirements.QualificationEducation and/or Experience2–4 years of experience in healthcare billing, accountsreceivable, or revenue cycle operations.Working knowledge of payer rules, billing regulations, andclaims submission processes.Experience with electronic health record (EHR) and billingplatforms (PointClickCare or similar).Strong analytical skills with the ability to identify trends,resolve billing issues, and ensure data accuracy.Excellent attention to detail, documentation habits, andorganizational skills.Ability to communicate effectively with Business OfficeManagers, payers, and cross-functional teams.Key CompetenciesTechnical Proficiency: Advanced knowledge of PointClickCare and Waystar (or similar clearinghouses).Professionalism: Demonstrate high levels of autonomy, organization, and assertiveness when addressing billing discrepancies.Adaptability: Exhibit flexibility and a cooperative spirit in a fast-paced, multi-facility environmentPhysical Demands2–4 years of experience in healthcare billing, accounts receivable, or revenue cycle operations.Working knowledge of payer rules, billing regulations, and claims submission processes.Experience with electronic health record (EHR) and billing platforms (e.g., PointClickCare, Waystar or similar).Strong analytical skills with the ability to identify trends, resolve billing issues, and ensure data accuracy.Excellent attention to detail, documentation habits, and organizational skills.Ability to communicate effectively with Business Office Managers, payers, and cross-functional teams.Salary Range: $80,000 - $100,000 annuallyWork EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individualswith disabilities to perform the essential functions.The noise level in the work environment is usually low to moderate.Additional InformationNote: Nothing in this job specification restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Critical features of this job are described under various headings above.They may be subject to change at any time due to reasonable accommodation or other reasons. The above statements are strictly intended to describe the general nature and level of the work being performed. They are not intended to be construed as a complete list of all responsibilities, duties, and skills required of employees in this position.We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other legally protected status. #J-18808-Ljbffr PAC