Specialist, Billing

Role: Specialist, Billing

Location: Remote. Must work in a location within the United States.

Travel: No travel required

Classification: Hourly, Non-Exempt

Reports to: Revenue Cycle Leadership

Salary Range: Commensurate with experience

About the role

The Billing Specialist role is responsible for ensuring the accurate and timely submission of claims, with a focus on identifying, correcting, and preventing billing edits and claim rejections, as well as resolving insurance balances and ensuring accurate and prompt reimbursement. This role is essential to achieving high clean-claim rates and minimizing denials and payment delays for our clients. An effective Billing Specialist is a detail-oriented problem solver, and thrives in a dynamic, fast-paced environment.

Responsibilities

• Resolve and/0r remedy claim errors, edits and rejections to ensure proper and timely submission to payers. 
• Monitor assigned reports and worklists within the patient accounting system, clearinghouse, and/or payer portals, promptly identifying and resolving claim edits and rejections with accuracy and efficiency.
• Follow up with insurance companies regarding the status of outstanding claims and pursue appropriate steps for remedy. 
• Review and respond to insurance correspondence as needed to ensure complete and accurate reimbursement. 
• Identify and escalate trends to leadership to support process improvement, clean-claim performance, and optimize reimbursement.

• Maintain strong working knowledge of payer guidelines, billing rules, and relevant regulatory requirements applicable to assigned work.

• Consistently meet or exceed established productivity and quality standards.
• Effectively navigate multiple computer systems and applications simultaneously; documenting all actions taken in Revology and / or client platforms in accordance with operational protocols.
• Comply with and hold with utmost regard all compliance requirements to protect patient privacy and confidentiality. 
• Stay curious, kind and contribute positively to the Revology culture. The health + harmony of the team is everybody’s responsibility at Revology.

The statements stated in this job description reflect the general duties as necessary to describe the basic function, essential job duties/responsibilities, job requirements, physical requirements and working conditions typically required, and should not be considered an all-inclusive listing of the job.  Individuals may perform other duties as assigned, including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise balance the workload.

Requirements

• 3+ years of healthcare billing and insurance experience required.  
• Experience with claim clearinghouses (Waystar, Availity, Change Healthcare, etc.) highly preferred.

• Ability to work independently to accomplish goals in a dynamic environment.
• High school diploma or equivalent required; bachelor’s degree or equivalent experience preferred.
• An aptitude for problem-solving, patience and flexibility while working in the complex industry of healthcare revenue cycle. Excellent attention to detail.
• Ability to comfortably navigate a technology-focused setup to efficiently complete assigned work (multiple monitors + several applications open simultaneously).

Remote work requirements

Internet capability must be a high-speed internet connection of 40 Mbps speeds or greater.

Physical requirements

Must be able to perform physical activities, such as, but not limited to: moving or handling (lifting, pushing, pulling and reaching overhead) office equipment and supplies weighing 1 to 25 lbs. unassisted.  Frequently required to sit for extended periods during the workday.  Manual dexterity and visual acuity required.  Must be able to communicate effectively on the telephone and in person.

Working conditions

Work will generally be performed indoors in an office environment.  Must maintain a professional appearance and manner.  

Employment eligibility

Candidates must be legally authorized to work in the United States without sponsorship.