Revenue Cycle Billing Specialist

Remote
Part Time to Full Time
Mid Level
Job Summary:
We are seeking a detail-oriented and experienced Revenue Cycle Billing Specialist to join our team. This role is responsible for managing key revenue cycle processes, including patient registration, eligibility verification, benefits verification, prior authorizations, pre-collection of patient responsibility, charge entry, claims submission, claim rejections, and payment posting. This role is also responsible for managing patient billing functions, ensuring accurate invoicing, timely payments, and effective communication with patients regarding their financial responsibilities. The ideal candidate will have a strong background in medical billing, insurance follow-up, and patient account resolution.


Key Responsibilities:
  • Register patients accurately and verify demographic information.
  • Confirm patient eligibility and verify insurance benefits.
  • Obtain prior authorizations for procedures and services as required.
  • Calculate patient responsibility and facilitate pre-collection before service.
  • Accurately enter charges and ensure coding compliance.
  • Submit claims to insurance providers and government payers.
  • Monitor and resolve claim rejections promptly.
  • Post payments and adjustments to patient accounts.
  • Generate and send patient statements and invoices in a timely manner.
  • Review and verify patient billing information for accuracy and completeness.
  • Assist patients with billing inquiries and provide clear explanations of charges.
  • Process patient payments and set up payment plans as needed.
  • Follow up on outstanding patient balances and coordinate collection efforts.
  • Collaborate with insurance companies to ensure correct processing of patient claims.
  • Identify and resolve billing discrepancies and disputes.
  • Ensure compliance with HIPAA and other healthcare billing regulations.
  • Maintain accurate patient account records and documentation.
  • Provide reports on patient billing activities and account statuses.
Qualifications:
  • High school diploma or equivalent required; associate’s or bachelor’s degree in healthcare administration, finance, or related field preferred.
  • Minimum of 2 years of experience in medical billing or revenue cycle management.
  • Knowledge of medical billing practices, insurance claim processes, and patient financial services.
  • Proficiency in electronic health records (EHR) and billing software.
  • Strong attention to detail and problem-solving skills.
  • Excellent communication and customer service abilities.
  • Ability to work independently and manage multiple tasks efficiently.
  • Ability to handle sensitive financial discussions with patients professionally and empathetically.
Preferred Qualifications:
  • Certification in medical billing and coding (e.g., CPC, CCS, or CMRS).
  • Experience with Medicare and Medicaid billing.
  • Familiarity with managed care and commercial insurance plans.
  • Familiarity with financial assistance programs and patient advocacy.
Work Environment:
This position may be based in an office, healthcare facility, or remote setting, depending on organizational needs. Standard work hours apply, with occasional overtime as necessary to meet deadlines.
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