Billing & Collections Specialist I

U.S. Oral Surgery Management•Irving, TX

About The Position

The Billing & Collections Specialist I follows up on insurance and patient balances by obtaining claim status, researching rejections and denials, documenting account activity, and contacting patients about outstanding balances denied by insurance. The position communicates with patients, practice partners, insurance companies, and other revenue cycle management staff to support reimbursement and timely account resolution. The role uses billing and patient management systems, along with the My Transworld Health website, to update account and collection statuses, send statements, document disputes, and support payment collection. The specialist reviews aging reports and patient accounts, follows up on outstanding claims, resolves billing issues, processes refunds and adjustments when appropriate, and ensures applicable procedures are followed before accounts are referred to a collection agency. The specialist is expected to meet the accuracy rate set by the manager during training and maintain an accuracy rate of at least 96% thereafter. Additional duties may be assigned by the manager or director.

Requirements

High school diploma, GED, or equivalent.
Ability to manage multiple priorities with frequent interruptions.
Excellent oral and written communication skills.
Ability to meet deadlines.
Problem-solving skills.
Exceptional human relations skills.
Ability to work as a team player.
Proficiency with computers and patient management software.
Basic addition and subtraction skills.
Meet the accuracy rate determined by the manager during training and maintain 96% or better thereafter.
An equivalent combination of education and experience is acceptable.

Nice To Haves

Experience in a medical and/or dental environment.

Responsibilities

Respond to patients, practice partners, and coworkers by telephone, email, and Teams messages regarding balances, billing, collections, and reimbursement.
Use the My Transworld Health website to send patient accounts to profit recovery and collections.
Update My TSI with information about patients’ failure to pay remaining balances when they submit disputes.
Email statements to patients regarding remaining balances and bad debt, and maintain a record of statements and billing emails sent to patients for the practice.
Update billing systems to reflect collection status and patient payments.
Identify issues that may impede insurance or patient payments and collaborate with the manager on resolutions.
Explain benefits, balances, and the reasons for collections to patients.
Run weekly aging reports, monitor outstanding insurance claims, and contact insurers to investigate outstanding, rejected, or pending claims.
Review errors and resolve related issues.
Review patient accounts with credit balances and issue refunds when necessary.
Verify that insurance payments are correct and issue adjustments in accordance with state law and USOSM protocol.
Create account contact notes with reminder dates to support timely claim follow-up.
Pull zero-pay claims, apply insurance adjustments, and update billing categories.
Follow required procedures before referring patient balances to a collection agency.
Process credit-card payments taken over the phone or provide them to a poster for processing.
Communicate with the practice about accounts requiring discretionary adjustments.
Meet the manager’s accuracy standard during training and maintain an accuracy rate of 96% or better.
Perform additional duties as assigned by the manager or director.