Accounts Receivable - Billing Specialist – US Healthcare - Can Start ASAP!

The Billing Specialist – Healthcare is responsible for managing the end-to-end billing and collections process to ensure accurate and timely reimbursement from insurance payers and patients. This role involves reviewing claims, following up on outstanding accounts, resolving denials or discrepancies, and maintaining compliance with healthcare regulations and payer policies.

Key Responsibilities:

• Generate and submit claims to insurance companies, government programs (Medicare/Medicaid), and third-party payers in accordance with billing guidelines.
• Monitor and manage accounts receivable to ensure timely follow-up on unpaid claims.
• Investigate and resolve denied, rejected, or underpaid claims.
• Post payments and adjustments accurately to patient accounts.
• Contact insurance providers and patients via phone or email to resolve outstanding balances and discrepancies.
• Maintain up-to-date knowledge of payer requirements, billing codes, and healthcare regulations.
• Collaborate with internal departments (coding, eligibility, patient services) to resolve billing-related issues.
• Document all collection activities and maintain detailed records in the billing system.
• Meet or exceed productivity and quality standards related to collections, aging reports, and account resolution.

Qualifications:

• High school diploma or equivalent; associate degree in healthcare administration, accounting, or related field preferred.
• 2+ years of experience in medical billing and accounts receivable, preferably in a US healthcare environment.
• Strong knowledge of insurance types (Medicare, Medicaid, commercial payers, and VA).
• Familiarity with EHR/EMR and billing systems (e.g., EPIC, Athena, etc.).
• Proficiency in MS Office applications and billing software.
• Excellent communication and problem-solving skills.
• Ability to work independently and manage multiple tasks effectively.

Preferred Skills:

• Experience with denial management and appeals.
• Knowledge of HIPAA regulations and healthcare billing compliance.
• Prior experience in a BPO or RCM (Revenue Cycle Management) environment.