Billing Specialist

QuantumCare Wound Care | Nebraska’s Exclusive Independent Wound Care Partner QuantumCare is transforming the way healthcare is delivered. As a trusted participating provider within the Methodist Health Partners network and Nebraska’s only independent wound care center, we provide comprehensive services designed to support patients throughout every stage of their wound care journey. From advanced wound care and chronic condition management to transitional care, our experienced team brings compassionate, specialized treatment directly to patients-where they live, recover, and thrive. The Billing Specialist is responsible for analyzing, managing, and optimizing the financial operations related to billing, collections, and reimbursement within a healthcare organization. This role ensures accuracy, efficiency, and compliance throughout the entire revenue cycle process. Core Responsibilities Monitor and evaluate billing, collections, and accounts receivable data to identify trends and areas for improvement. Enter new referrals in the EHR/PM system, check eligibility, obtain prior authorization/IVR before appointment if applicable. Proactively follow up on referrals to confirm source, obtain missing or additional information, and ensure complete and accurate patient records prior to the first provider visit. Support front desk operations as needed, including patient intake coordination and communication to ensure a smooth check-in experience. Monitor daily performance on payer portals and with the RCM portal. Work closely with the Clinic Manager to ensure accurate charge capture and timely billing practices. Ensure adherence to federal, state, and payer-specific billing and coding regulations through regular audits and reviews. Assist with denial management and work claim rejections to maximize reimbursement. Compile data Smartsheet or Excel and report to the Practice Manager weekly. Contribute to the development and improvement of systems and workflows to increase efficiency. Serve as a liaison between clinical, billing, and administrative teams to resolve revenue cycle issues. Maintain up-to-date knowledge of industry changes, payer policies, and compliance requirements. Other duties as assigned Experience A bachelor's degree in finance, healthcare administration, accounting, or a related field is preferred, however 5 years relevant work experience would be highly considered. Strong analytical and problem-solving skills, proficiency in financial analysis tools, and excellent communication abilities are essential. Familiarity with healthcare regulations and billing practices is a must. The ability to work independently as well as collaborate with a team is required. Equal Opportunity Employer QuantumCare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. #J-18808-Ljbffr Quantum Medical Solutions LLC