billing and collections specialist

Southwest Ohio ENT Specialists Inc

<div>Description:

POSITION OVERVIEW
The Billing Specialist is responsible for Accounts Receivable Management, working all denied claims, seeks full payment from the specific insurance carriers they are responsible for. In addition, prepares appeals for incomplete or non-payments with proper documentation along with researching, analyzing and reconciling billing and reimbursement practices.
ESSENTIAL DUTIES AND RESPONSIBILITIES<ul><li>
Works in our practice management systems Collection Module and/or Aging Reports to identify aged/denied claims and pull necessary information to investigate claims.</li><li>
Actively follow-up on outstanding claim balances by checking claims on the carrier&rsquo;s website or by calling the insurance companies and other payers as needed.</li><li>
Prepare appeals paperwork for all payers by gathering supporting documentation as needed.</li><li>
Recognize and appropriately report problems or negative patterns in support of maximization of billing and collections.</li><li>
Work claims hitting edits in TriZetto Provider Solutions (Clearinghouse).</li><li>
Avoid and/or resolve errors which may lead to undo write-offs or insurance rejections.</li><li>
Identify accounts requiring charge or payment corrections.</li><li>
Credentialing new physicians, nurse practitioners, audiologists and SLP&rsquo;s for the insurance carriers they are responsible for.</li><li>
Run collection reports per physician call to collection outstanding balance prior to next visit or communicate to the scheduler to cancel appointment.</li><li>
Respond to emails from Patient Services team regarding patients in collections then calling the patient to collect outstanding balance.</li><li>
Phone work as scheduled to include incoming calls requesting account information and making outgoing calls for account investigation.</li><li>
Review weekly statements sending letters or emails to patients to collect payment prior to sending to collections.</li><li>
Provide backup phone coverage and other office responsibilities as a member of the Billing Team.</li><li>
Handle other duties and special projects as assigned.</li></ul>
Requirements:

EDUCATION, EXPERIENCE &amp; KNOWLEDGE REQUIREMENTS
Education<ul><li>
High School Diploma or equivalent</li></ul>
Experience<ul><li>
Minimum 3-5 years medical billing experience.</li></ul>
Knowledge &amp; Skills<ul><li>
Proficiency in using computers and ability to learn various software.</li><li>
Superior organizational and problem-solving skills, and attention to detail</li><li>
Familiarity with medical billing systems, ICD-10, CPT, medical coding, and basic medical terminology.</li><li>
Ability to work well in a team environment.</li><li>
Strong communication (verbal and written) skills.</li></ul></div>

Billing Specialist

Gregory Poole Equipment Company

PRIMARY FUNCTION: 
Manage all aspects of customer onboarding, account maintenance, and credit extension in accordance with GPEC’s Credit Policies and Procedures and manage assigned third-party billing portal set up and registration of accounts, assist sales in the collection of payment on equipment sale invoices in accordance with established procedures. Track discrepancies and make sure all payments are entered, matched, and allocated properly on a timely basis. The overall goal is to increase customer satisfaction, in addition to adhering to established policies and procedures to increase efficiencies in billing and collections of these accounts. Work closely with service, parts, rental, collections, and accounts receivable departments to ensure timely payment on all accounts. This role will work with operations on in-process work orders to ensure we are meeting customer requirements in a timely manner for invoicing.
 
ESSENTIAL DUTIES: 
Credit
 <ul>
<li>Ensures customer credit limits are within established credit policy by reviewing credit applications, analyzing credit histories and financial statements, and establishing customer credit limits.</li>
<li>Ensures that proper customer credit documentation is obtained and maintained for potential future credit or legal actions.</li>
<li>Works directly with Assistant Credit Management on exceptions.</li>
</ul>
Customer Setup
 <ul>
<li>Responsible for creating and maintaining customer credit accounts within required systems including GPAX and BillTrust and ensuring all customer account maintenance is accurate and completed in a timely manner.</li>
<li>Responsible for obtaining tax certificates and other relevant information, documenting, and maintaining in our systems for future reference and support in the event of audit or legal actions arise.</li>
</ul>
Equipment Sale Collections
 <ul>
<li>Assist sales department in the collection of payment on Equipment sale invoices in accordance with established procedures to ensure timely payment and reducing debt loss for the company.</li>
</ul>
Registration of All Third-Party Billing Systems: 
<ul>
<li>Review documentation for set up and attend training.</li>
<li>Document, maintain, update all requirements for each system.</li>
<li>Review of Terms and Conditions with Supervisor.</li>
<li>Process fees for approval related to these systems and determine allocation by predetermined guidelines.</li>
<li>Review need for all departments interaction and discuss with all departments to ensure the requirements can be met at the time of registration.</li>
</ul>
3rd Party Customer Account Set Up Requesting and Verification:
 <ul>
<li>Review Customer account requirements.</li>
<li>Provide back up to main account set up role (for credit) mainly for 3rd party/portal accounts.</li>
<li>Verify that customer’s accounts are set up properly in AX to meet needs for all departments interfacing with the customers. This includes but not limited to terms and conditions, credit limits, proper ship to addresses and proper taxes.</li>
<li>Verify that order account invoices are mailed to the proper location for the customer through BillTrust or current system being used based on data provided by customer or operations.</li>
<li>Maintain or modify accounts as required throughout life of account.</li>
</ul>
Account Invoicing and Reconciliation: 
<ul>
<li>Input invoice information into appropriate billing portal, daily, for select EPG accounts assigned as well as any other third-party portal for other divisions as assigned.</li>
<li>If any issues at the time of entry of the invoice, address as needed with appropriate personnel or department.</li>
<li>If possible, allocate credit with invoice before entered into the portal and send to the customers.</li>
<li>Review and reconcile accounts on a weekly basis.</li>
<li>Document any updates, notes, discussions on account for reference.</li>
<li>Reconcile, allocate and provide analysis of ILFT third party (HYG Fleet) accounts and ensure timely and accurate posting at least weekly.</li>
<li>Prepare journal entries and vouchers, if necessary, to keep the accounts within terms</li>
<li>Identify all invoices that are not claimed in the SLMS system or any other portal if reporting is available and timely notify operations.</li>
</ul>
Collection Analysis: 
<ul>
<li>Identify WIP from last labor that is associated with billing portals if available through GPAX reporting.</li>
<li>Assist collectors with investigating 3rd party/ portal customers invoices that are in a past due status according to the terms on the account or legal contracts signed.</li>
<li>Communicate with operations and/or collector on any discrepancies in payment.</li>
<li>Communicate with appropriate department on disputed invoices.</li>
<li>Utilize AX business system and processes to make recommendations for actions needed to assist in collection. (i.e. Service, Parts, and Rental in addition to Credit functions)</li>
<li>Extract data, analyze, present and report trends from systems.</li>
</ul>
Customer Relations: 
<ul>
<li>Build relationships with assigned customer accounts and billing portal contacts.</li>
<li>Work closely with operational and support areas to ensure good communications between groups.</li>
<li>Openly communicate with credit personnel on new account adds and edits.</li>
<li>Coordinate with marketing department on any equipment set up or movement of equipment to proper accounts.</li>
</ul>
MINIMUM REQUIREMENTS:Education: 
Four-year college graduate preferably with Business Administration/Accounting classes with 2 years’ relevant experience, or an associate’s degree with 4 years of relevant experience in similar industry
 
Work Experience: 
(see above)
 
Physical: 
Must be able to sit and use a PC for long periods of time.
 
Other: 
Must be able to work independently and resourcefully.
 Must have excellent communication skills, verbal and written.
 Preferred intermediate/advanced computer skills, preferably advanced Excel knowledge, to analyze data
 
Gregory Poole Equipment Company is an Equal Opportunity/Affirmative Action employer and will consider all qualified applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

Credit/Reconciliation Analyst

I Am Boundless

<div>Summary/Objective
Responsible for accurately processing patient billing, managing insurance claims, and ensuring timely reimbursement. Duties include reviewing medical records, coding procedures, and collaborating with healthcare providers and insurance companies to resolve discrepancies. Strong attention to detail, knowledge of medical terminology, and proficiency in billing software are essential for success in this role.
Essential Functions<ul><li>Verifies insurance benefits and confirm patient eligibility</li><li>Obtains prior authorization for services as required</li><li>Reviews clinician entered charges entered for accuracy before generating claims</li><li>Prepares and submits claim files</li><li>Posts insurance and clients payments accurately and in a timely manner</li><li>Analyze and address ERA/EOB denials by taking appropriate corrective action</li><li>Manage accounts receivable and actively pursue outstanding balances</li><li>Oversee client collections to ensure timely payment</li><li>Handle insurance appeals for denied or underpaid claims</li><li>Stay informed and compliant with payor reimbursement policies, procedures, and guidelines</li><li>Monitor and apply contracted fee schedules to ensure accurate expected payment</li><li>Foster positive communication and relationships with patients, clinicians, physicians, third-party payors, and other Boundless staff)to ensure exceptional customer service</li><li>Adheres to company policies and procedures in addition to regulations, laws and other requirements from applicable governing bodies, certification, licensure and/or accreditation entities, etc.</li><li>INCLUDE STATEMENT ABOUT WORKSPACES OR ENVIRONMENTS THAT THIS POSITION WILL TYPICALLY WORK</li></ul>
Other Responsibilities<ul><li>Other duties as assigned.</li></ul>
Supervisory Duties
This position has no supervisory responsibilities.
Education, Skills, Experience and Requirements<ul><li>High school diploma required; college coursework a plus.</li><li>Preferred 1-3 years&rsquo; experience in medical billing and collections, as well as insurance verification.</li><li>Proficient in Microsoft 365</li><li>Medical Coding Certification (Preferred)</li><li>Driver&rsquo;s license and insurable driving record, if applicable.</li></ul>
Competencies and Attributes
Oral and written communication
Professionalism
Organizational skills
Ability to stay focused
Ability to prioritize multiple tasks
Computer skills
Professional phone etiquette
Physical Demands/% of time
Lifting and carrying up to 20lbs &lt;25%
Standing and/or walking &lt;25%
Near visual acuity &gt;75%
Use of electronics (i.e. computer, tablet) &gt;75%
Manual dexterity &gt;75%
Use of office equipment (i.e. copier/scanner) &gt;75%
Sitting &gt;75%
Verbal communication &gt;75%
Work Hours: Typically Monday through Friday from 8 am to 4:30 pm-this position works remotely
Travel Requirements: Minimul travel is primarily local during the business day</div>

Medical Billing and Accounts Receivable Specialist

Total Orthopedics & Sports Medicine

We are seeking a dedicated Medical Billing AR Specialist with a strong background in managing accounts receivable billing and collection of payments for all designated payors and locations in order to meet and maintain our goal to join our dynamic team. You will be responsible for transferring patient and insurance information and initiating payment processes and procedures. The ideal candidate will be well-versed in billing software, medical insurance regulations, and an expert at responding to patient and insurance inquiries. You will also be responsible for maintaining patient confidentiality, handling personal information, and accurately inputting patient data into the system.Responsibilities:<ul><li>Identifies and resolves billing inquiries/problems</li><li>Codes services provided utilizing CPT and ICD-10 coding</li><li>Experience with Medicare, Commercial, Worker's Comp and No-Fault claims follow up</li><li>Knowledge of Medical Terminology, ICD-10, CPT codes and the correct use of modifiers</li><li>Working rejections from the clearinghouse to correct errors for resubmissions</li><li>Generates and submits electronic claims and statements at designated intervals; corrects any errors for complete and accurate transmission of data</li><li>Able to handle patient inquiries regarding billing issues, out of network issues, and explaining insurance guidelines to patients</li><li>Read and analyze patient records to determine correct codes for billing to insurance provider</li><li>Prepares letters of appeal to insurance companies if the company refuses to pay contracted claims and/or denies a claim; submits documentation necessary to support claim; resubmits claims with corrections if needed for payment for all insurance payers</li><li>Researches and processes refund requests and overpayments</li><li>Prepares correspondence and/or collection letters</li><li>Performs other related duties as assigned by senior management</li></ul>Requirements:<ul><li>Proficiency in medical terminology and ICD-9 / ICD-10 coding</li><li>Experience with insurance verification and prior authorizations</li><li>Strong attention to detail and data entry accuracy</li><li>Excellent communication and organizational skills</li></ul>Benefits:<ul><li>401(k) matching</li><li>Dental insurance</li><li>Disability insurance</li><li>Health insurance</li><li>Company paid Life insurance and optional voluntary insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person: Relocate before starting work (Required)Our company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, sexual orientation, gender identity, or gender expression in terms of all conditions of employment. Our diversity is one of our greatest strengths, and as an Equal Opportunity Employer, we are proud to promote a work environment where all differences are respected.Job Type: Full-timePay: $25.00 - $28.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Health insurance</li><li>Health savings account</li><li>Paid time off</li><li>Parental leave</li><li>Vision insurance</li></ul>Experience:<ul><li>Medical billing: 1 year (Preferred)</li></ul>Ability to Commute:<ul><li>Syosset, NY 11791 (Required)</li></ul>Work Location: In person

Medical Billing Accounts Receivable (AR) Specialist

Kaweah Health

<div>Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.
It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do &mdash; in the health of our patients, our loved ones, and our community.
Benefits Eligible
Full-Time Benefit Eligible
Work Shift
Day - 8 Hour or less Shift (United States of America)
Department
8530 Patient Financial Services
Maintains complete and full knowledge of payer(s) assigned to ensure accurate billing and collection of the claims. Validates that the Kaweah Health is being reimbursed by the payer in accordance with government or contract terms.
QUALIFICATIONS
Education
Preferred: High school diploma or equivalent
Experience
Required: Prior Patient Accounting or admissions experience. Comparable medical billing education may be considered.
JOB RESPONSIBILITIES
Essential
Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring the Kaweah Health is being reimbursed by the payer in accordance with governmental or contract terms. Is a resource to Finance division management regarding the assigned payer.
Brings any reimbursement or compliance concerns to the attention of the Patient Accounting Manager.
Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company and plan, and charges. 100% accuracy of this information is required to ensure proper recording of revenue, necessary authorizations are obtained, payer classification, correct billing of patient account, and other statistical indicators. Brings any unresolved issues to the attention of their manager.
Audits unbilled reports for potential holdups of patient accounts. Works closely with Medical Records on coding issues, Insurance Verification Clerk on insurance issues and other departments as necessary.
Completes billing process. Ensures all charges are accurate and appropriate. Payer guidelines will be followed during the billing process. After billing has been completed, uses appropriate charge description master (CDM) number to identify the payer and when the account was billed. Works closely with departments on unresolved issues.
Reviews and researches patient account credits and refunds as appropriate to patient and/or payer. For governmental payers, has the credit retracted.
Receives all correspondence and inquiries related to patient accounts and payer contract for which they are responsible. Answers mail and take appropriate action within specified timeframe.
Bills any secondary payers, change financial classes accordingly and sends appropriate collection system letter to patient for co-pays and deductibles owed, denied services, amounts applied to deductible, etc. Uses correct CDM code to identify what secondary payer was billed and when.
Reviews and works aging reports to identify unpaid patient accounts. Follows up with payers for timely reimbursement.
Works to ensure that days in accounts receivable goals are met maintained and/or lowered. Maintains job productivity and quality standards on a consistent basis as established by division management.
Answers phones as a back up to other departmental staff. Takes messages or routes calls as appropriate. As back up, assists customers at the service counter.
Conforms with patient confidentiality standards.
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
Performs other duties as assigned.
Addendum (essential for specific dept)
Insurance or managed care payer:
Has complete knowledge of assigned insurance payer, knows contract terms, requirements and payment practices.
Receives prior day's explanation of benefits or remittance advices for assigned payer(s). Reviews to ensure that appropriate contractual adjustments have been taken by payer. Works closely with payer to resolve issues and brings continued problems to the attention of their manager.
Monitors patient accounts for secondary payer reimbursement.
Medicare payer:
Gets electronic remittance advice (R/A) ready for the Accounts Receivable Clerks. Distributes Medicare mail.
Reviews DRG worksheet for accuracy of reimbursement. Reviews all denied changes for appropriateness.
Reviews the Pending Billing List report and deletes non-covered services. Checks for overlapping claims through accounts receivable inquiry (ARI).
Reviews and processes recurring accounts according to procedure.
If responsible for professional billing, processes these bills according to procedure.
Reviews and follow up on the DDE system.
Medi-Cal payer:
Maintains full and complete knowledge of the regulations governing the Medi-Cal payer.
Reviews the Pending Billing List report and/or the Final Accounts and Cycle Billed report. Follow up is completed according to procedure.
Reviews and processes R/A's following procedure.
Reviews MEDTRIEVE data to identify problems in billing. Reviews statistical data with their Manager to maximize reimbursement
Reviews Medi-Cal TAR Dashboard weekly for any follow up on approved or denied TARs.
Self-pay accounts:
Responsible for the administration of the Computer Collection letter service interface (CCI) process.
Prepares and completes the bad debt write-off and assignment to the collection agency.
Acts as a liaison to the collection agency and works with patients regarding hospital accounts assigned.
Responsible to identify patient accounts that may qualify for charity care. Works with patients who inquire about charity program.
Monitors patient accounts pending the Medi-Cal disability process and/or TCMS program.
Responsible for the estate lien filing in the case of deceased patients to assure that the Kaweah Health receives payment on accounts.
Lead also responsible for:
May be responsible for educating individuals in the Patient Accounting Department on new processes and/or payment regulations.
May be assigned to develop training curriculum on new processes.
Provides department staff with information regarding updates or changes.
May serve as a Subject Matter Expert (SME) for systems issues and claim payment issues.
Identifies, investigates, and appropriately communicates account errors in order to prevent further errors.
Proactively and critically analyzes departmental processes and products, makes continuous improvements.
Keeps the Director of Patient Financial Services informed of any potential issues or areas of concern on an ongoing basis.
Pay Range
$23.37 -$35.05
If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.</div>

Patient Account Specialist

Cala Sourcing Solutions LLC

<div>Billing &amp; Trust Accounting Specialist 
Miami, FL (Onsite) | $70&ndash;75K + Full Benefits - Start date: Asap
We&rsquo;ve partnered with a well-established Miami law firm seeking a Billing &amp; Trust Accounting Specialist to join their accounting team. This is a full-time, in-office role offering strong visibility with leadership and the opportunity to own billing operations, trust accounting, and collections processes. If you&rsquo;re a detail-driven billing professional who enjoys working closely with attorneys and leadership to ensure accurate billing and strong collections, this is a great opportunity to join a reputable firm.
What you&rsquo;ll be responsible for:<ul><li>
Full-cycle legal billing (traditional + electronic)</li><li>
Applying client billing guidelines, rates, and fee structures</li><li>
Managing pre-bills, edits, transfers, and attorney follow-ups</li><li>
Monitoring e-billing platforms, resolving rejections, and tracking approvals</li><li>
Reconciling invoices and submissions within TABS</li><li>
Processing client payments and resolving account discrepancies</li><li>
Supporting collections efforts (statements, follow-ups, aging)</li><li>
Handling trust accounting transactions (deposits, wires, disbursements) in TABS</li><li>
Preparing weekly billing reports and forecasts for leadership</li><li>
Assisting with billing goals, reporting needs, and special projects</li></ul>
What you bring:<ul><li>
3&ndash;5 years of law firm billing experience (required)</li><li>
Experience with electronic billing platforms</li><li>
TABS3 experience strongly preferred</li><li>
Strong attention to detail and organization</li><li>
Analytical mindset with solid math skills</li><li>
Ability to generate and present reports</li><li>
Proficiency in Microsoft Office (Excel preferred)</li><li>
Strong communication skills in a fast-paced environment</li><li>
Bilingual English/Spanish is a plus</li></ul>
 Start Date: ASAP
#Workwolf</div>

Billing and Trust Accounting Specialist

Wholistic Health and Wellness LLC

Job Overview We are seeking a Medical Billing Specialist familiar with Waystar Clearing House to join our healthcare team. In this vital role, you will be responsible for managing the full cycle of medical billing processes, ensuring accurate and timely submission of claims, and optimizing revenue flow. Your expertise will support the financial health of our practice while providing exceptional service to patients and providers alike. This position offers an exciting opportunity to apply your medical coding knowledge and billing skills in a fast-paced, collaborative environment dedicated to quality care.This position will not require much of your time and will allow you to apply your billing knowledge from the comfort of your home.You must be familiar with Waystar!Access to computer/laptop and printer is also recommended!We need your expertise today! Call us now (614)429-8731Responsibilities<ul><li>Prepare and submit insurance claims accurately using CPT (Current Procedural Terminology), ICD-9, and ICD-10 coding systems, ensuring compliance with payer guidelines, and ERA complianc.</li><li>Review medical records and documentation to verify the accuracy of diagnoses, procedures, and billing codes.</li><li>Follow up on unpaid or denied claims through effective communication with insurance companies and patients to facilitate prompt resolution.</li><li>Maintain detailed records of billing activities, payment histories, and correspondence within Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems.</li><li>Collaborate with healthcare providers to clarify documentation requirements and ensure proper coding for DRG (Diagnosis-Related Group) assignments when applicable.</li><li>Monitor accounts receivable and perform collections for outstanding balances through professional outreach to patients or third-party payers.</li><li>Stay current with evolving healthcare regulations, coding updates, and billing best practices to ensure compliance and maximize reimbursement.</li></ul>Skills<ul><li>Strong understanding of medical terminology, medical records management, and healthcare documentation standards.</li><li>Proficiency in medical coding including CPT, ICD-9, ICD-10, DRG, and ICD coding systems.</li><li>Experience with medical billing processes, insurance claim submission, and medical collections.</li><li>Familiarity with EMR/EHR systems used for recording patient information and billing data.</li><li>Excellent attention to detail with the ability to analyze complex medical information accurately.</li><li>Effective communication skills for interacting with insurance companies, healthcare providers, and patients.</li><li>Knowledge of healthcare regulations related to billing practices and patient confidentiality. Join us as a Medical Billing Specialist to make a meaningful impact by ensuring smooth financial operations in a supportive healthcare environment!</li></ul>Pay: $50.00 - $100.00 per dayBenefits:<ul><li>Employee discount</li><li>Flexible schedule</li></ul>Work Location: Remote

Medical Billing Specialist

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