Medical Billing Accounts Receivable Specialist

Job Description

Job Description

The insurance biller is responsible for preparing, submitting, and resolving insurance claims for both physician and ASC facility services. This role uses Epic billing workflows to ensure timely and accurate claim submission, correct claim edits, manage rejections, and follow up on outstanding accounts. The biller plays a key role in reducing A/R days, improving clean claim rates, and maximizing reimbursement in compliance with payer rules and organizational policies.

This position is on-site and requires regular attendance at our Stonemill location. Remote work is not available for this role.

Responsibilities:

• Support an environment that reinforces Rebound’s mission and Core Values of Superior Service, Teamwork, Integrity, Innovation, Quality and Recognition.
• Submit professional and facility claims electronically through Epics module and clearinghouse interface.
• Validate claim data using Charge Review and Claim Edit work queues, correction errors prior to submission.
• Confirm insurance coverage, place of service, provider information, and coding accuracy prior to release.
• Resubmit corrected claims when needed and follow up on rejected or pended submissions.
• Work assigned Charge Review, Claim Edit, and Follow up work queues daily to ensure clean claims and timely payer responses.
• Route claims to coding or registration or contracting teams when discrepancies impact billing.
• Identify trends or repeat edit issues and escalate to management or system support for root cause resolution.
• Review payer rejections and denials in Epic and take appropriate action to correct and resubmit claims.
• Coordinate with insurance companies via web portals or phone calls to resolve claims issues.
• Document all actions taken in account notes to ensure audit trail and communication across teams
• Follow all CMS and commercial payer billing guidelines, including NCCI edits, modifiers, and place of service requirements.
• Stay updated on payer-specific requirements for both professional and facility claims
• Maintain knowledge of billing for multiple service lines, including E&M, surgical procedures and ancillary services.
• Maintain a high degree of confidentiality and abide by all HIPAA rules and regulations.
• Perform other duties as assigned.

Qualifications:

• High school graduate or equivalent required.
• College level accounting or business courses preferred.
• Minimum of two years experience in medical billing in a healthcare related field, physician’s office, hospital or clinic.
• Experience in the field of collections, customer service, and insurance billing and reimbursement preferred. Working knowledge of CPT/ICD10 coding, HCPCS, modifiers and payer billing guidelines.
• Experience with Medicare, Medicaid and commercial payers. ASC billing knowledge preferred.
• Additional appropriate education may be substituted for applicable experience or an equivalent combination of education, training and/or experience.
• Knowledge of insurance billing procedures, collection laws, and medical terminology preferred.
• Excellent communication and public relations skills, both verbal and written.
• Ability to work both independently and interdependently with staff and team members with limited supervision.
• Excellent problem solving and critical thinking skills.
• Proficient use of computers including MS Office applications.
• Must demonstrate an understanding of the principles of service excellence and be able to maintain a professional demeanor and customer service orientation under busy and difficult situations.

Physical Requirements and Working Conditions:

• Work may require sitting for long periods of time
• Stooping, bending and stretching for files and supplies.
• Occasionally lifting files or paper weighing up to 30 pounds.
• Requires manual dexterity sufficient to operate a keyboard, type at 35 wpm, operate a calculator, telephone, copier and other office equipment as necessary.
• It is necessary to view and type on computer screens for long periods.
• Works in close proximity to business office personnel within limited work space. Interaction with others and phones is often disruptive.
• Tasks are of minimal hazardous conditions.

We are Proud to Offer:

• Medical/Vision/Rx
• Dental
• 401(K) Retirement Plan, including discretionary profit sharing and Cash Balance Plan
• Company paid Life Insurance/AD&D
• Voluntary Life insurance/AD&D
• Company paid short and long-term disability
• Flexible Spending and Health Saving Accounts
• Employee Assistance Program
• Free Parking
• Paid Time Off accrued at up to 24 days in your first year based on FTE

This is a great opportunity to work in a quality organization with Top Doctors in the Northwest. At Rebound, our goal is to cultivate an organization that offers superior patient-centered medical care, with mutual respect and cooperation in a positive and supportive environment. Come join our team!

This position works on-site Monday-Fridays, no weekends or holidays.
This is a full-time, 40 hour per week position.