Overview
This is a fully remote position for a Billing Specialist within a growing Healthcare Revenue team. The role focuses on managing all areas of the revenue cycle for specific clinics and departments, ensuring compliance, accuracy, and maximum reimbursement.
Responsibilities
- Review medical records and assign appropriate diagnosis and procedure codes following guidelines.
- Perform timely revenue cycle tasks within EPIC, including charge review, claim editing, payment posting, accounts receivable follow-up, refunds, patient support, and billing performance monitoring.
- Collaborate closely with Clinic Department Managers, Health Services Administrators, Patient Services Representatives, Coders, EPIC Site Specialists, and vendors to manage the entire revenue cycle.
- Monitor and follow up on outstanding claims, denials, and appeals to resolve billing discrepancies.
- Prepare and maintain billing reports, metrics, and documentation to track billing activities, revenue trends, and collections performance.
- Meet and exceed patient satisfaction goals aligned with the organization's mission.
- Participate in special department or payer projects.
- Assist with payment posting, credentialing projects, fee schedule analysis, and other projects supporting the healthcare revenue cycle department.
- Adhere to all agency policies including confidentiality, corporate compliance, standards of conduct, and training requirements.
Requirements
- High school diploma or equivalent required; associate degree preferred.
- Minimum 2-3 years of experience in medical billing or healthcare revenue cycle management, preferably in a clinic or healthcare setting.
- Proficiency with EPIC Resolute Billing.
- Strong experience with Microsoft Office applications.
- Knowledge of CPT and ICD-10 coding and familiarity with medical terminology.
- Experience filing claim appeals with insurance companies to ensure compliant and maximum reimbursement.
- Excellent customer service skills.
- Strong written and verbal communication skills.
- Meticulous attention to detail in reviewing billing codes, claims, and payments.
- Strong analytical skills to identify trends and resolve billing issues.
- Ability to manage relationships with insurance payers, credentialing managers, and regional payer representatives.
- Understanding of HIPAA compliance and responsible handling of confidential information.
- Ability to manage multiple projects and work respectfully with colleagues, clients, and patients.
- Effective problem-solving skills and a proactive attitude to resolve billing discrepancies, denials, and appeals promptly.
- Commitment to staying updated on industry trends, regulations, and best practices in medical billing and revenue cycle management.
Preferred Qualifications
- Experience working in HIV care within a not-for-profit environment.
Compensation & Benefits
- Hourly pay range: $24.00 - $25.00, depending on experience.
- Generous paid time off including 12 paid holidays.
- 401(k) plan with 100% employer match up to 5%.
- 12 weeks of fully paid parental leave.
- Employer-subsidized medical, dental, vision, and gender-affirming care benefits.
- Employer-paid short and long-term disability insurance.
- Tuition reimbursement, certification, and licensure assistance.
- Benefits available for part-time roles.
- Employment may qualify for federal student loan forgiveness programs as a not-for-profit employer.
Location
- This is a fully remote role.
Equal Opportunity Statement
The organization is an equal opportunity employer and recruits, hires, promotes, and transfers qualified persons without regard to race, gender, religion, skin color, national origin, physical or mental disability, age, gender identity, sexual orientation, medical condition, family care status, marital status, veteran status, genetic characteristics, or any other characteristic protected by law. The employer complies with all applicable federal, state, and local regulations regarding protected classifications.
The organization is committed to fostering a respectful, inclusive, and supportive environment for all individuals, particularly those affected by HIV, and values diversity, equity, inclusion, and belonging in its workforce.
Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
As a recipient of federal funding, the organization will not hire or contract with any party debarred, suspended, or excluded from federal assistance programs.