Billing and Follow Up Specialist

Medical Billing and Follow Up Specialist - Full-time - Asheville / NC - North Carolina (May consider Remote Option)*

Please contact: recruitment@broadriverrehab.com for further details!

We currently have a full-time Medical Billing and Follow Up Specialist opportunity at our corporate office in Asheville, NC / North Carolina, with the option for a remote position!

Broad River Rehabilitation partners with skilled nursing and assisted living facilities to provide exceptional physical, occupational and speech therapy services.

Position Overview:
We are seeking an experienced and detail-oriented Lead Biller to join our team. This role is responsible for the full revenue cycle process, including claim submission, insurance follow-up, payment posting, appeals, and resolution of outstanding accounts, with a focus on patients in assisted living and skilled nursing settings. The ideal candidate will have a strong background in therapy billing and a working knowledge of insurance regulations and medical terminology.

Key Responsibilities:

• Ensure timely and accurate submission of claims to all payers, including private insurance, Medicare, and Medicaid.
• Verifying and reviewing therapist-entered charges and patient diagnoses for coding accuracy and compliance.
• Post payments and adjustments to patient accounts with a high degree of accuracy.
• Initiate and manage appeals for denied or underpaid claims; consult with management on complex cases.
• Communicate effectively with insurance carriers to resolve claim issues and verify reimbursement criteria.
• Provide required medical records and documentation to payers as needed.
• Perform insurance verifications and clearly communicate authorization requirements and outcomes.
• Proactively perform claims follow-up on outstanding accounts receivable, including researching unpaid, denied, or partially paid claims and taking appropriate action to ensure timely resolution and reimbursement.
• Analyze payer responses, remittance advice, and denial codes to identify root causes and implement corrective actions.
• Escalate complex or unresolved issues appropriately while maintaining clear documentation of all follow-up activities.
• Identify trends in denials or payment delays and communicate findings to leadership to support process improvement and revenue optimization.
• Maintain up-to-date knowledge of coding guidelines, including ICD-10, CPT codes, and payer-specific requirements.
• Consistently meet internal and external processing and reporting deadlines.
• Demonstrate a willingness to cross-train and assist in other billing-related departments such as credentialing and insurance verification, as needed.

Qualifications:

Education:

• High school diploma or GED required.

Experience:

• Minimum of 3 years of experience in medical billing required.
• Experience in both facility and outpatient billing; therapy billing experience is strongly preferred.
• Familiarity with NetHealth and Waystar platforms is a plus.
• Previous provider credentialing experience preferred
• Strong team player
• proactive and self-motivated
• well-rounded in all aspects of medical billing and follow up
• Particularly skilled with technology and systems

Skills and Competencies:

• Proficient in interpreting fee schedules and applying medical coding standards (ICD-10, CPT).
• Strong verbal and written communication skills.
• Exceptional attention to detail with the ability to prioritize and multitask effectively.
• Independent thinker with strong problem-solving abilities.
• Excellent customer service skills and a team-oriented mindset.
• Proficient in medical office terminology and documentation best practices.
• Flexible and open to cross-functional training and support across billing operations.
• Strong understanding of claims lifecycle and accounts receivable (A/R) follow-up processes.
• Ability to analyze remittance advice (EOBs/ERAs) and denial codes to determine appropriate follow-up actions.
• Experience working aging reports and prioritizing accounts based on timeliness, payer guidelines, and dollar value.
• Knowledge of payer-specific requirements, including Medicare and Medicaid regulations related to billing and follow-up.
• Ability to identify denial trends and recommend process improvements to reduce future claim issues.
• Highly organized with the ability to manage follow-up queues and maintain thorough documentation of account activity.
• Persistent and results-driven with a focus on timely resolution of outstanding claims and maximizing reimbursement.

We offer a wonderful work environment with a fantastic team already in place and looking to add one more!

Medical Billing and Follow Up Specialist - Full-time - Asheville / NC - North Carolina

Medical Billing and Follow Up Specialist - Full-time - Asheville / NC - North Carolina