Billing and Collection Specialist-Remote

Job Summary: The Billing and Collections Specialist is responsible for confirming all claims for professional services that have been submitted, including denial management, payment accuracy verification for all professional services.

Primary Responsibilities:

• Demonstrated experience in healthcare billing and collection requirements of all third-party payers, including government regulations and procedures.

• Follow up on unpaid claims and outstanding balances due from insurance payers.

• Initiate or assist with appeals, rebilling and needed inquiries until resolved.

• Assist, if needed, with insurance verification and payer covered.

• Research and obtain necessary information to successfully respond to insurance (payer) denials.

• Record and log claim follow up action taken in a designated collections tracker.

• Ensure all professional services payments are reported / applied to the patient’s account.

• Communicate with providers and internal teams such as the RestorixHealth Coding team, Coding Manager, Prior-Auth, Practice Manager, and VP if / when needed.

• Maintain appropriate files and reports.

• Collaborate and provide Practice Manager and / or VP Revenue Cycle, with regular updates on all outstanding issues.

• Maintain the confidentiality of all patients, hospitals, nursing homes, and / or provider information.

• Administer and uphold all the Company’s values, policies, and procedures.

• Continuously work towards ensuring all possible revenue for the Professional Services Division is billed and collected timely.

• Report and advise on any needed write-offs expeditiously and timely.

• Collaborate with Practice Manager on account updates to facilitate needed monthly reporting.

• Provide back up support to Practice Manager when needed to cover PTO / time off.

• Support and perform Professional Services other assigned duties as needed.

Educational and Technical Skills:

• Must have high school diploma or GED equivalent with at least two years’ experience as a medical biller, coder, collections specialist, healthcare claims filing or auditing in a medical facility (out-patient facility), medical practice, office, or agency

• General understanding and working knowledge of ICD-10 and CPT/HCPCS coding

• Must have intermediate skills in Microsoft Word, Excel, and Outlook

• Must have experience working with electronic medical records (EMR) system

• Must have a valid driver’s license for the entire time the position is held Additional

Eligibility Qualifications / Competencies:

• Excellent interpersonal, verbal, and written communication skills

• Strong organizational skills and attention to detail

• Strong follow-up skills required

• Diversity - Demonstrates knowledge of Equal Employment Opportunity (EEO) policy; shows respect and sensitivity for cultural differences; educates others on the value of diversity; promotes a harassment-free environment; builds a diverse workforce.

• Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and principles; upholds organizational values

Physical Requirements: This position requires periods of time in which sitting, standing, use of repetitive hand and foot motion, as well as vision, hearing, summarizing, all while focusing with frequent interruptions along with other physical, sensory, and cognitive sensory functions.

Note: The above is intended to describe the general content of and requirements for the performance of this job. It is not construed as an exhaustive statement of duties, responsibilities or requirements and may change at any time.

The Company is an Equal Opportunity Employer (EEO). All qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, disability, or protected veteran status.