Billing Specialist

Job Description We are seeking an experienced Accounts Receivable Specialist with a strong background in medical billing and collections. This role is fully onsite and requires a high level of accuracy, industry knowledge, and the ability to work in a fast-paced healthcare environment. Qualifications & Experience Minimum of 3 years of accounts receivable experience in medical billing. At least 1 year of experience in the behavioral health industry. Proficiency in UB04, CMS 1500, ICD-10, CPT, and HCPCS coding. Advanced Excel knowledge required. Familiarity with payer portals, payment posting, and electronic health record (EHR/EMR) systems. Strong understanding of medical terminology and billing/collection practices. Skills Knowledge of healthcare rules and regulations, including the False Claims Act. Experience with government and commercial payer billing, as well as patient billing. Excellent verbal and written communication skills; comfortable presenting in group settings. Strong critical thinking, organizational, and time management skills. Ability to work independently, manage multiple tasks, and meet deadlines. Detail-oriented with a focus on accuracy and compliance. Responsibilities Verify patient insurance coverage and obtain payer authorizations. Collect and validate information required for claims submission. Work with insurance companies, healthcare providers, and patients to resolve and process claims. Review and appeal unpaid or denied claims. Post payments accurately across multiple systems and business units. Monitor accounts to ensure timely collections and proper documentation. Review remittance advices for denials, identifying trends and escalating issues as needed. Stay current with federal, state, and local billing/collection regulations and payer guidelines. Maintain accurate medical billing files and manage accounts receivable reports. Enter insurance payments promptly and apply contractual, patient, and other adjustments. Participate in special projects and support additional responsibilities as assigned. Ensure compliance with HIPAA regulations and uphold organizational values.

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