Overview
A healthcare organization is seeking a full-time Billing Specialist to join their team remotely (Texas only). This role involves managing billing and coding processes primarily for pediatric urgent care services, with a focus on accuracy, compliance, and efficient claims management.
Responsibilities
- Manage charge capture, coding, billing, and billing edits.
- Coordinate with providers and medical directors to develop accurate templates and automated billing processes.
- Analyze trends affecting charges, coding, and collections; adjust staff and policies accordingly.
- Review billing and claims for accuracy and completeness; submit claims to insurance entities and follow up on issues.
- Ensure compliance with coding and billing guidelines.
- Maintain systems, policies, and procedures to meet payer contractual obligations.
- Monitor reimbursements and stay current with federal and state regulations.
- Communicate effectively with staff, assist with updates, issue resolution, goal setting, and standards maintenance.
- Assist with work allocation, problem resolution, and month-end reporting.
- Perform billing/payment posting functions and follow up on unpaid or improperly paid claims.
- Review and monitor select accounts receivable.
- Conduct collection efforts including online, phone, and written correspondence.
- Apply company EMR protocols correctly regarding invoice balances and statuses.
- Build claims using medical terminology and ICD/CPT codes.
- Correct denied claims promptly and document accordingly.
- Submit claims electronically and by paper.
- Handle telephone inquiries and billing questions professionally.
- Generate and review patient statements; ensure appropriate collection correspondence is sent and documented.
Requirements
- High school diploma or equivalent required; Associate's or Bachelor's degree in Finance, Accounting, Business Administration, or related field preferred.
- Minimum 3 years of billing and coding experience in healthcare, including urgent care, ABA therapy, or similar services.
- In-depth knowledge of medical billing; pediatric billing experience preferred.
- Experience with practice management/EMR systems, preferably eMDs and Waystar.
- Comprehensive knowledge of coding, billing processes, and payer requirements.
- Familiarity with local payers and claims resolution processes.
- Understanding of physician practice technology related to claims.
- Knowledge of physiology, anatomy, neurology, and medical terminology.
- Strong written and verbal communication skills.
- Ability to work independently with attention to detail and accuracy.
- Excellent interpersonal skills and professionalism.
- Ability to work remotely and collaboratively within a team.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
- Ability to operate fax machine, copier, and scanner.
- Passion for revenue cycle management and a positive mindset.
- Bilingual skills are a plus.
- Employment verification through E-Verify.
Benefits
- Medical, dental, and vision insurance for employees, spouses, and dependents.
- Voluntary short-term and long-term disability insurance.
- Voluntary life insurance for employees, spouses, and children.
- 401(k) plan with 4% company match on 5% employee contribution.
- Holiday pay; closed on Thanksgiving and Christmas with shorter holiday hours.
- 80 hours of paid time off (PTO) accrued annually with rollover options.
- Additional PTO accrued after three and five years of service.
- Free in-house medical care for employees and dependent children.
- Employee recognition and appreciation programs.
- Professional development opportunities.
Location
- This is a 100% remote position available to candidates located in Texas only.