BILLING AND COLLECTIONS SPECIALIST
About The Position
The Billing & Collection Specialist plays a critical role in managing financial transactions, ensuring billing accuracy, and maintaining regulatory compliance. This position is responsible for accurate and timely billing for assigned service lines, analyzing patient accounts, identifying and resolving overpayments, processing refunds, and managing credit balances in accordance with established policies and industry regulations. This role contributes directly to the organization’s revenue cycle performance by supporting and achieving key accounts receivable (AR) metrics and goals. Key Performance Objectives Net and Gross Days Outstanding in Accounts Receivable Percentage of Accounts Receivable Aged > 90 Days Cash Collection Goals Credit Balances as a Percentage of Outstanding Receivables Denial Resolution and Prevention
Requirements
- Strong understanding of medical terminology, insurance billing practices, and reimbursement processes
- Experience with electronic health record (EHR) systems and billing platforms (e.g., Meditech or similar)
- Excellent analytical skills with strong attention to detail
- Prior experience in healthcare billing, revenue cycle management, or accounts receivable preferred
Nice To Haves
- Associate’s degree in Healthcare Administration, Finance, Accounting, or related field preferred
Responsibilities
- Perform daily activities to ensure timely resolution and closure of aged accounts receivable
- Submit claims, correct claim errors, and resolve RTP (Return to Provider) issues
- Conduct account status reviews and follow-up with payers as needed
- Investigate and resolve credit balances in compliance with regulations
- Respond to and resolve claim denials, including root cause analysis
- Manage correspondence related to billing and collections
- Support external audit requests, particularly those related to credit balances
- Ensure compliance with all payer guidelines and regulatory requirements
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
251-500 employees
