healthcare billing specialist

Therapy Alliance of Michigan

Overview We are seeking a detail-oriented and proactive Billing and Credentialing Specialist to join our dynamic healthcare team. In this vital role, you will ensure accurate billing processes, manage provider credentialing, and maintain compliance with industry standards. Your expertise will directly contribute to the seamless operation of our healthcare services, supporting both administrative efficiency and high-quality patient care. This position offers an exciting opportunity to work in a fast-paced environment where your skills in managed care, medical terminology, and compliance standards will make a meaningful impact.Responsibilities<ul><li>Manage the complete billing cycle, including claim submission, follow-up, and resolution of denials to optimize revenue flow.</li><li>Verify insurance coverage and benefits through managed care plans to ensure accurate billing and reimbursement.</li><li>Maintain up-to-date provider credentials by coordinating with insurance companies and credentialing organizations in accordance with NCQA (National Committee for Quality Assurance) standards.</li><li>Review medical documentation for accuracy and completeness, ensuring compliance with healthcare regulations and industry best practices.</li><li>Collaborate with medical offices to gather necessary documentation and resolve credentialing issues promptly.</li><li>Stay informed about changes in managed care policies, healthcare regulations, and NCQA standards to ensure ongoing compliance.</li><li>Prepare detailed reports on billing activities, credentialing status, and compliance metrics for management review.</li></ul>Experience<ul><li>Proven experience in medical billing, coding, or related administrative roles within a healthcare setting.</li><li>Strong understanding of managed care processes and insurance claim procedures.</li><li>Prior medical office experience is highly preferred, demonstrating familiarity with healthcare workflows.</li><li>Knowledge of medical terminology is essential for accurate documentation review and communication.</li><li>Experience working in environments that adhere to NCQA standards or similar accreditation requirements is a plus.</li><li>Excellent organizational skills with the ability to manage multiple priorities efficiently.</li><li>Strong communication skills to collaborate effectively with providers, insurance companies, and internal teams. Join us as a Billing and Credentialing Specialist and be part of a dedicated team committed to delivering exceptional healthcare services through precision, compliance, and compassionate support!</li></ul>Pay: $21.00 - $24.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Flexible schedule</li><li>Paid time off</li></ul>Work Location: Hybrid remote in Warren, MI 48093

Billing and Credentialing Specialist

Monarch Healthcare Management

<div>Monarch Healthcare Management Benefits Include:<ul><li>
UKG Wallet - get paid the next day!</li><li>
Free Single Medical Insurance</li><li>
Loan reimbursement.</li><li>
Scholarship Opportunities</li><li>
Paid Time Off &ndash; Vacation Time</li><li>
401 (k) with annual contribution match</li><li>
Referral bonuses</li><li>
Career path to other positions within our growing company!</li></ul>
AR Billing Specialist
Position Summary:
The AR Billing Specialist I is responsible for assisting with various billing processes, verifying eligibility, uploading deposit records, and ensuring accurate documentation and compliance with payer requirements. The position requires attention to detail and effective collaboration with other team members to ensure smooth and accurate billing operations.
Qualifications:<ul><li>
High school diploma or equivalent.</li><li>
Minimum of 1-2 years of experience in medical billing, healthcare administration, or a related field</li><li>
Associate's degree in healthcare administration, business, accounting, or related field.</li><li>
Relevant certifications (e.g., Certified Billing and Coding Specialist)</li></ul><ul><li>
Experience with billing systems such as PCC (Point Click Care) or similar platforms</li><li>
Knowledge of Medicare, Medicaid, and other insurance payer systems.</li><li>
Prior experience with long-term care (LTC) or skilled nursing facilities (SNF).</li><li>
Familiarity with eligibility verification, aging reports, and census reporting.</li></ul>
About Monarch:
Monarch Healthcare Management is a mission-driven company that is changing the way short-term rehabilitation and long-term care are delivered. Our employees embody our motto, Where CARE and CUSTOMER SERVICE Come Together, by always putting the needs of residents and families first across Monarch's network of 60+ skilled nursing and assisted living facilities in Minnesota. 
Partnering with higher research institutes and international tech companies, Monarch has been nationally recognized for its innovation in the care of our residents, making a meaningful impact on their quality of life and interactions. 
We value our employees and work hard to attract and retain the best talent by offering a positive and supportive work environment along with competitive pay, fun perks, career development opportunities, and great benefits. 
We are an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.</div>

AR Billing Specialist I Eagan

PMTAC Pvt Ltd

Job Title: SNF Medicare Billing Specialist &ndash; PDPM (Skilled Nursing Facility)Location: Rawalpindi, Pakistan (Onsite) Company: PMTAC Pvt. Ltd. Shift: Night Shift (US Healthcare)Position OverviewPMTAC is seeking an experienced SNF Medicare Billing Specialist with strong knowledge of the Patient-Driven Payment Model (PDPM) and Skilled Nursing Facility (SNF) Medicare Part A billing requirements. The ideal candidate will have hands-on experience with MDS-driven reimbursement, HIPPS coding, and UB-04 claim submission.This role requires a strong understanding of Centers for Medicare &amp; Medicaid Services (CMS) billing guidelines and compliance regulations.Key Responsibilities1. Medicare Eligibility Verification<ul><li>Verify Medicare Part A coverage for SNF residents.</li><li>Confirm qualifying 3-day hospital stay and benefit period.</li><li>Review secondary insurance coverage (Medicaid, Medicare Advantage, commercial payers).</li></ul>2. MDS &amp; PDPM Coordination<ul><li>Review and ensure accurate completion of Minimum Data Set (MDS) assessments.</li><li>Validate:</li><li>Clinical conditions</li><li>Functional status</li><li>Comorbidities</li><li>Confirm HIPPS code generation from MDS.</li><li>Ensure documentation supports PDPM classification.</li><li>Understand and apply the guidelines of the Patient-Driven Payment Model.</li></ul>3. UB-04 (CMS-1450) Claim Preparation<ul><li>Prepare and submit facility claims using the UB-04 (CMS-1450) form.</li><li>Accurately complete required fields including:</li><li>Type of Bill (21X)</li><li>Statement Covers Period</li><li>Revenue Codes (0022&ndash;0029 for PDPM)</li><li>HIPPS Code</li><li>Units (covered days)</li><li>Total Charges</li><li>Occurrence Codes (qualifying hospital stay)</li><li>Ensure proper reporting of PDPM per diem billing structure.</li></ul>4. Claim Submission &amp; Follow-Up<ul><li>Submit claims electronically via EDI/clearinghouse or CMS DDE.</li><li>Work with Medicare Administrative Contractors (MACs).</li><li>Monitor claim status and resolve denials or RTPs.</li><li>Submit corrected claims when MDS or HIPPS codes change.</li></ul>5. Payment Reconciliation &amp; Post-Processing<ul><li>Post Medicare payments and reconcile PDPM variable per diem rates.</li><li>Identify underpayments or discrepancies.</li><li>Coordinate professional claims (CMS-1500) separately from facility billing.</li></ul>6. Compliance &amp; Audit Readiness<ul><li>Ensure clinical documentation supports billed services.</li><li>Maintain compliance with CMS and Medicare billing regulations.</li><li>Assist with audits and ADR responses.</li></ul>Required Qualifications<ul><li>Minimum 2&ndash;3 years of SNF Medicare Part A billing experience.</li><li>Strong knowledge of PDPM reimbursement methodology.</li><li>Experience working with MDS assessments and HIPPS coding.</li><li>Proficiency in UB-04 (CMS-1450) claim preparation.</li><li>Understanding of revenue codes 0022&ndash;0029.</li><li>Familiarity with Medicare Administrative Contractors (MACs).</li><li>Experience with electronic billing systems and clearinghouses.</li><li>Strong attention to detail and regulatory compliance knowledge.</li></ul>Preferred Qualifications<ul><li>RHIT, RHIA, CPC, or CPB certification.</li><li>Experience in long-term care or post-acute care settings.</li><li>Knowledge of Medicare Advantage SNF billing.</li></ul>Core Competencies<ul><li>Knowledge of PDPM case-mix components (PT, OT, SLP, Nursing, NTA).</li><li>Understanding of variable per diem adjustments.</li><li>Ability to analyze MDS-driven reimbursement.</li><li>Strong denial management skills.</li><li>Excellent documentation review and audit readiness skills.</li></ul>Interested candidates with SNF Medicare Billing Specialist are encouraged to apply by sharing their CV at: careers@pmtac.coma.arslan@pmtac.com Subject: SNF Medicare Billing SpecialistJob Type: Full-timePay: Rs80,000.00 - Rs150,000.00 per monthExperience:<ul><li>SNF Medicare PDPM billing: 2 years (Required)</li><li>MDS assessments and HIPPS coding: 2 years (Required)</li><li>UB-04 (CMS-1450) claim preparation: 2 years (Required)</li></ul>License/Certification:<ul><li>RHIT, RHIA, CPC, or CPB certification (Required)</li></ul>Location:<ul><li>Rawalpindi (Required)</li></ul>Work Location: In person

SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

Acellus Hospital

Job descriptionJob Vacancy: Billing Executive / Senior Executive Department: Billing Experience: 2 - 7 years (Healthcare/Hospital industry preferred) Employment Type: Full-timeAbout Us:We are currently seeking a motivated and detail-oriented Billing Executive / Senior Executive to strengthen our Revenue Cycle Management team.Key Responsibilities:<ul><li>Prepare and process patient bills accurately and in a timely manner</li><li>Handle TPA and insurance claims processing and documentation</li><li>Verify services rendered and coordinate with clinical departments for accurate billing</li><li>Reconcile billing reports and follow up on payment discrepancies</li><li>Ensure compliance with hospital billing policies and statutory regulations</li><li>Address patient and relative queries related to billing and insurance</li><li>Generate and maintain MIS reports and support internal audits</li><li>Collaborate with internal teams for smooth revenue cycle operations</li></ul>Key Skills:<ul><li>Hospital Billing &amp; Invoicing</li><li>TPA &amp; Insurance Claims Processing</li><li>Revenue Cycle Management (RCM)</li><li>Healthcare Billing Software</li><li>Billing Reconciliation &amp; Reporting</li><li>Strong Analytical and Problem-Solving Skills</li><li>Excellent Communication &amp; Interpersonal Skills</li><li>Proficient in MS Excel and data handling</li><li>Attention to Detail and Accuracy</li><li>Knowledge of Healthcare Regulations and Compliance</li></ul>Educational Qualifications:<ul><li>Bachelors degree in Commerce, Accounting, Finance, or a related field (mandatory)</li><li>Masters degree (MBA or equivalent) in Finance or Healthcare Management (preferred for Senior Executive role)</li></ul>Why Join Us?<ul><li>Work with a reputed healthcare institution</li><li>Competitive salary and benefits</li><li>Professional development and growth opportunities</li><li>Supportive work environment focused on excellence and ethics</li></ul>Interested candidates may share their CV via email (careers@acellushospital.com) or contact us at 7777857900 for more information.Job Type: Full-timePay: ₹15,000.00 - ₹25,000.00 per monthWork Location: In person

Billing Executive

Cliniqon RCM Pvt Ltd

Key Responsibilities<ul><li>Prepare and send client invoices on time</li><li>Manage Accounts Receivable (AR) and track outstanding payments</li><li>Follow up with US clients for collections through calls</li><li>Update and maintain records in QuickBooks</li><li>Reconcile invoices, payments, and AR aging</li><li>Coordinate with internal teams to resolve billing issues</li><li>Ensure compliance with US healthcare billing and accounting standards</li><li>Prepare AR and invoicing reports for management</li></ul>Required Skills &amp; Qualifications<ul><li>M-com/ Ca inter2&ndash;3 years of experience in US Healthcare accounting or AR</li><li>Good working knowledge of QuickBooks</li><li>Experience in AR follow-ups and collections</li><li>Comfortable speaking with US clients over calls</li><li>Good verbal and written communication with neutral accent</li><li>Understanding of invoicing cycles and payment terms</li><li>Attention to detail and ability to meet deadlines</li></ul>Preferred Qualifications<ul><li>Experience working with US healthcare providers or billing companies</li><li>Knowledge of US healthcare billing terms</li><li>Experience handling multiple client accounts</li></ul>Job Types: Full-time, PermanentPay: ₹25,000.00 - ₹35,000.00 per monthBenefits:<ul><li>Food provided</li><li>Health insurance</li><li>Provident Fund</li></ul>Work Location: In person

Accounts Executive - US

FNA Truck Dispatch

About UsHK Technologies is a growing healthcare services provider committed to delivering accurate, efficient, and compliant medical billing solutions. We are seeking a motivated and detail-oriented individual to join our team as a Medical Billing Trainee.Job SummaryThe Medical Billing Trainee will receive hands-on training in medical billing processes, insurance claim submission, payment posting, and revenue cycle management. This role is ideal for individuals looking to start a career in healthcare administration.Key Responsibilities<ul><li>Learn and assist with medical coding and billing procedures</li><li>Prepare and submit insurance claims accurately and timely</li><li>Verify patient insurance eligibility and benefits</li><li>Follow up on unpaid or denied claims</li><li>Maintain patient billing records and confidentiality</li><li>Assist with payment posting and account reconciliation</li><li>Ensure compliance with healthcare regulations and company policies</li></ul>Requirements<ul><li>Bachelors degree</li><li>Basic knowledge of medical terminology (preferred but not required)</li><li>Strong attention to detail and accuracy</li><li>Good communication and computer skills</li><li>Willingness to learn and work in a team environment</li></ul>What We Offer<ul><li>On-the-job training</li><li>Career growth opportunities</li><li>Supportive work environment</li><li>Competitive entry-level salary</li></ul>Job Types: Full-time, Contract Contract length: 24 monthsWork Location: In person

Medical Billing Trainee

Aspirion

<div>Description:

For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, aged accounts receivables, motor vehicle accident, workers&rsquo; compensation, Veterans Affairs, and out-of-state Medicaid.
At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, &ldquo;Our teammates are the foundation of our success.&rdquo; United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time.
We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor.
We are seeking an Appeals Specialist II to join our growing team. As an Appeals Specialist II, you will be exposed to the complex reimbursement methodology between hospitals and insurance companies. Appeals Specialists work closely with assigned project teams on the specialized retrospective recovery process. You will be exposed to the revenue cycle process and various provider clients and systems.
Key Responsibilities<ul><li>
Follow-up with insurance carriers on underpaid claims by phone; complete follow-up actions as advised</li><li>
Research claim variances in hospital patient accounting systems (EPIC, Meditech, Cerner, Athena)</li><li>
Draft appeals to insurance carriers on denied or underpaid claims</li><li>
Review claim detail including coding, billing and insurance information for discrepancies</li><li>
Run claims data through various pricing software</li></ul>
Requirements:
<ul><li>Strong healthcare industry knowledge</li><li>
Ability to troubleshoot and remedy claim submission errors</li><li>
Demonstrated attention to detail</li><li>
Excellent written and verbal communication skills</li><li>
Team-Oriented and Flexible</li><li>
Creative Problem-solving skills</li></ul>
Education and Experience<ul><li>
High School Diploma or GED required; bachelor's degree preferred</li><li>
Hospital billing experience required</li><li>
Previous work from home experience</li></ul>
Benefits
At Aspirion we invest in our employees by offering a full benefits package, including health, dental, vision and life insurance upon hire, matching 401k, competitive salaries, advancement opportunities, and incentive programs.
The US base pay range for this position starts at $19.00 hourly. Individual pay is determined by a number of factors including, but not limited to, job-related skills, experience, education, training, licensure or certifications obtained. Market, location and organizational factors are also considered. In addition to base salary, a competitive benefits package is offered.
AAP/EEO Statement
Equal Opportunity Employer/Drug-Free Workplace: Aspirion is an Equal Employment Opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, pregnancy, religion, national origin, ancestry, medical condition, marital status, gender identity citizenship status, veteran status, disability, or veteran status. Aspirion has a Drug-Free Workplace Policy in effect that is strictly adhered to.
Please note that this position is contingent upon the successful completion of a pre-employment drug screening and background check. These steps are part of our standard hiring process to ensure a safe and compliant workplace.</div>

Appeals Specialist - Hospital Billing, Underpayments

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