Billing Operations Specialist

Alteva RCM•New York, NY

6h•$90,000 - $120,000

About The Position

The Billing Operations Specialist is an operational partner to the Billing Operations Manager and Billing Department leadership, supporting day-to-day billing operations across claim intake, billing, quality assurance, and coding coordination. The role helps ensure claim information is received, entered into the billing system, and billed accurately in line with billing and coding guidelines, healthcare regulations, and payer-specific requirements. It maintains trackers, reporting, documentation, and follow-up to keep workflows visible and on track. The specialist provides first-line triage of productivity issues, workflow concerns, and escalations, and brings data-backed insights to leadership. The position supports clean claim submission, reduced rework, timely reimbursement, compliance, quality assurance, process improvement, and coordination across billing and operational teams.

Requirements

Bachelor's degree or equivalent professional experience.
3–5 years supporting billing operations, revenue cycle management, healthcare administration, executive support, or business operations.
Advanced Excel proficiency, including pivots, summaries, and charts, and comfort building reports from data exports.
Proficiency with standard office productivity and collaboration tools.
Exceptional organizational, planning, communication, follow-up, and time-management skills.
Ability to work independently, exercise sound judgment, protect confidential information, and deliver results with minimal supervision.
Working knowledge of HIPAA regulations and healthcare privacy laws, with the ability to handle protected information in compliance.
Ownership and consistent follow-through on billing priorities, open items, and leadership requests.
Ability to operate independently while recognizing when billing accuracy, client communication, compliance, or workflow risk requires escalation.
Professional, confident, clear, and persistent communication across billing and cross-functional teams.
Ability to thrive in a fast-paced billing environment with competing priorities, urgent escalations, and frequent workflow changes.

Nice To Haves

Strong understanding of medical billing workflows, including claim intake, coding handoffs, billing rules, provider rosters, payer requirements, documentation gaps, and claim lifecycle tracking.
Experience with billing, workflow, and reporting systems.
Healthcare, revenue cycle management, specialty billing, or professional services experience.

Responsibilities

Partner with the Billing Operations Manager and Billing Department leadership to manage priorities and support day-to-day billing, claim intake, and QA workflows.
Monitor output, backlog levels, queue health, and operational risks; flag systemic issues to leadership with supporting data.
Triage day-to-day productivity issues and workflow concerns by logging issues, gathering details, and routing them to the appropriate team lead or Billing Operations Manager.
Monitor urgent escalations, workflow blockers, and client-impacting issues, escalating when appropriate.
Compile volume, backlog, and coverage data to support staffing, workload management, and capacity assessments.
Support hiring, onboarding, and performance evaluation logistics, including scheduling, scorecards, and interview materials.
Coordinate leadership calendars and meetings; prepare agendas and notes; record decisions, action items, owners, and deadlines; and follow up with stakeholders.
Support alignment of workflows, priorities, and performance standards across billing and claim intake teams.
Identify bottlenecks, repeated errors, and rework drivers, and bring improvement recommendations to leadership.
Support standardization of workflows, escalation protocols, and quality controls.
Build and maintain Excel-based analyses, dashboards, and reports from claims and ticket data exports, including accuracy rates, turnaround time, rework rate, and backlog aging.
Track implementation of client-specific billing rules, provider rosters, tax ID rules, directory billing guidelines, account statuses, and workflow changes.
Maintain billing documentation, including SOPs, workflows, process maps, rollout instructions, tracker standards, and version-controlled reference materials.
Support adherence to payer requirements, HIPAA regulations, and internal SOPs by maintaining accurate documentation and flagging potential compliance risks.
Support billing audits, QA activities, and data validation; compile trends in audit findings from QA data.
Track corrective actions for errors or audit findings through timely completion.
Serve as a liaison among Billing Department leadership, the Workflow Manager, Billing Team Managers, Claim Intake Team leadership, QA, coding, onboarding, IT/product partners, client service, and other operational teams.
Communicate billing priorities, workflow changes, deadlines, and escalation items clearly and professionally.
Document requirements and track follow-up with IT and product partners on billing platform and ticketing system requests.