Overview
This part-time Billing Specialist role (up to 25 hours per week) involves providing medical billing and collections expertise during customer engagements. The position requires knowledge of medical billing and collections processes for governmental and commercial insurance payers. The specialist will manage open Accounts Receivable (A/R), contact insurance companies, generate and resubmit claims, and resolve outstanding balances to optimize reimbursement and reduce A/R.
The role demands adaptability to shifting priorities and support for evolving client and Revenue Cycle initiatives as business needs arise. Most work is performed remotely, and travel is generally not required.
Responsibilities
- Perform billing and collections duties as assigned.
- Maintain and prioritize weekly worklists aimed at optimizing revenue and reducing A/R.
- Support client-driven Revenue Cycle and Billing projects as business needs evolve.
- Demonstrate flexibility and assist with operational priorities outside routine responsibilities when needed.
- Identify and report system or process issues to management.
- Maintain professionalism, honesty, and integrity in all interactions.
- Protect Protected Health Information (PHI) and ensure compliance with HIPAA and data security standards at all times.
Required Skills and Knowledge
- Experience in medical billing and collections with governmental and/or commercial payers.
- Knowledge of payer requirements and billing regulations.
- Experience with MEDITECH Expanse.
- Experience working with Facility and Professional claims.
- Strong organizational, analytical, and problem-solving skills.
- Ability to adapt quickly, take ownership of emerging needs, and work collaboratively in a fast-paced environment.
- Ability to work independently in a remote setting while maintaining productivity and professionalism.
- Private and secure remote workspace required to protect PHI.
Preferred Skills
- Strong communication skills and ability to work effectively under pressure.
- Team-oriented professional with a strong work ethic and customer-focused mindset.
- Certification in Medical Billing/Collections or 5+ years of related experience.
- Experience with Epic, MEDITECH, and Cerner EMR systems.
- Intermediate to advanced Microsoft Excel skills.
- Demonstrated commitment to customer satisfaction and operational excellence.
Knowledge Areas
- Governmental and Commercial Billing
- Eligibility Verification
- Aging A/R Follow-Up
- Denial Remediation
- 837 Claim Resubmission
- EOB/ERA Cash Posting
- 835 Remit Interpretation
- Claim Clearinghouse Processes
- Reason and Remark Codes
- Prior Authorization Requirements
- Patient Data Validation
- CPT Codes and Modifiers
- ICD-10 Diagnosis Codes
- Insurance Websites and Portals
- Epic, MEDITECH, and Cerner systems
Language Skills
- Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
- Ability to write reports, business correspondence, and procedure manuals.
- Ability to effectively present information and respond to questions from a variety of internal and external sources.
Physical Requirements
- Regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear.
- Occasionally required to stand and walk.
- Must occasionally lift and/or move up to 10 pounds.
- Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
Equal Opportunity
The employer is an equal opportunity organization. All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.
Additional Information
This job description may not encompass all responsibilities and standards assigned to the position. Duties may change over time. Nothing in this description constitutes a contract for employment.