Billing Specialist - RCM

Remote

Full Time

Experienced

Job Overview

Restore First Health is seeking a highly organized and detail-oriented Billing Specialist to join our Revenue Cycle Management team. The Billing Specialist will play a critical role in managing and processing patient billing, insurance claims, and payments. The ideal candidate will have a strong understanding of medical billing procedures, including coding and insurance follow-up, ensuring accuracy and compliance with healthcare regulations. This position will report directly to the Revenue Cycle Manager and collaborate with various departments to support efficient billing processes and resolve patient account issues.

Key Responsibilities

Billing and Invoicing: Prepare, review, and send patient bills and invoices for services rendered, ensuring accuracy and adherence to company policies.
Claims Processing: Submit insurance claims electronically or by mail, follow up on denials, and ensure timely resolution of issues.
Payment Posting: Record and reconcile payments received from insurance companies, patients, and other third-party payers.
Account Reconciliation: Regularly review patient accounts to ensure correct balances and resolve discrepancies.
Insurance Follow-Up: Work with insurance companies to resolve unpaid or denied claims, and provide additional documentation as needed.
Patient Communication: Respond to patient inquiries about their bills, explain insurance coverage, and assist with payment arrangements or financial assistance.
Compliance: Ensure billing practices are compliant with healthcare regulations, including HIPAA and other legal requirements.
Reporting: Generate billing reports, track payment trends, and provide updates to the Revenue Cycle Manager on the status of accounts receivable.
Collaboration: Work closely with the Revenue Cycle Manager and other departments, including Finance and Customer Service, to optimize billing and revenue cycle operations.

Qualifications & Requirements

High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Finance, or related field preferred.
Strong background in credentialing with government and advantage plans.
Minimum of 2 years of experience in medical billing or healthcare revenue cycle management.
Proficiency in billing software, electronic health record (EHR) systems, and insurance claim submission processes.
Experience with ICD-10, CPT, and HCPCS coding is highly desirable.
Knowledge of insurance guidelines, including Medicare and Medicaid.
Strong computer skills, including proficiency with MS Office (Word, Excel) and billing software.
Strong attention to detail and organizational skills.
Excellent communication and interpersonal skills.
Previous working knowledge of Athena EMR. Athena EMR Super User a plus.
Ability to work independently and as part of a team.
Understanding of healthcare regulations, including HIPAA.
Ability to prioritize tasks and meet deadlines in a fast-paced environment.
This is a remote position. Some travel may be required from time to time.

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Billing Specialist - RCM

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