Original listing text, shown exactly as published by the company.
Position Responsibilities may include, but not limited to
- Create billing reports of assigned agencies
- Submit accounts receivable claims and/or invoices for weekly/monthly billing of assigned agencies
- Reconciliation of assigned state or local agencies
- Research and resubmit of billings to assigned agencies
- Review quality assurance of all referrals or updated clients from assigned state or local agencies
- Make outbound & inbound calls, emails to assigned state or local agencies with the purpose of securing correct information regarding new referrals, updated clients, and billings
- Responsible for executing complex billing tasks, mentoring junior staff, and leading cross-functional initiatives
- Reduce payment agency backlog
- Perform in-depth audits of project data to identify and resolve billing discrepancies
- Demonstrate successful performance through accuracy, timeliness, and customer satisfaction metrics
- Utilize advanced Excel functions (e.g., VLOOKUP) and reporting tools in CRM and SharePoint
- Manage complex billing scenarios including denials, rejections, and aging accounts
- Collaborate with Posting teams to resolve discrepancies and support month-end close
- Prepare and submit electronic claims, paper claims, and invoices (CMS-1500, UBs, invoices, and payer portals, etc.)
- Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans
- Ensure accurate and compliant billing, following specific regulations of multi-state Medicaid and MCO's, Medicare Advantage, and Older Americans Act programs
- Responsible for ensuring aged outstanding balances of assigned payers is kept within department standards
- Participate in process improvement initiatives. Collaborate across teams to resolve issues, claims denials, and aging
- Other tasks as assigned, including but not limited to, assisting with projects that impact collections or write offs
Required Skills and Experience
- High School Diploma or GED
- 2+ years of work-related experience in healthcare related field, ie, healthcare billing institutional and professional claims, patient registration, and/or patient access
- Intermediate level Excel skills
- Strong oral and written communication skills
- Ability to multi-task, set priorities, and pays close attention to detail
- Strong ability to work with team members across multiple departments
- Ability to work unsupervised with strong critical thinking and problem-solving skills
- Experience with Waystar, CRM, D365, and/or electronic health record platforms
- Must have a wired internet connection using an ethernet port. Broadband internet wired to the home is required - Cable Modem/service or Fiber Optic. No Satellite, 4/5G, or DSL circuits
- Must have a quiet workspace that is free from distraction
Preferred Skills and Experience
- Bachelor's degree in healthcare administration, medical administrative assistance, or healthcare finance
- Previous experience with electronic claims, such as electronic 835/837 claim and remit files, Zirmed, and/or secure payer web portals
- AAHAM and/or HFMA certification
- Knowledge of CMS regulation and strong familiarity with healthcare billing standards and compliance
- Experience with Waystar, CRM, D365, and/or electronic health record platforms
Physical Requirements
- Repetitive motions that include the wrists, hands and/or fingers…
