Billing Specialist - Remote

Gateway Rehabilitation Center Corp HQPittsburgh, PA
Remote

About The Position

Gateway Rehab Center (GRC) is seeking a remote Billing Specialist who is detail-oriented, passionate about accuracy, and thrives in a fast-paced environment. This role is responsible for the billing of patient services, performing follow-up on outstanding accounts receivable, processing refunds, patient denials, and write-offs. The position receives infrequent supervision and instruction from the Manager of Billing Services.

Requirements

  • High School diploma or equivalent required.
  • Minimum of one year billing experience.
  • Pass a PA Criminal Background Check
  • Obtain PA Child Abuse and FBI Fingerprinting Clearances
  • Pass Drug Screen
  • 2-Step TB Test

Nice To Haves

  • Understanding of healthcare billing practices
  • Familiarity with commercial insurance providers, including prior authorizations and claim submissions.
  • Knowledge of the full billing cycle, including charge entry, claims processing, payment posting, and collections.
  • Knowledge of basic accounting principles.
  • Understanding of patient privacy laws and healthcare compliance standards.

Responsibilities

  • Processes, edits, audits and posts service entries into the EHR.
  • Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
  • Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
  • Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
  • Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
  • Participates in the monthly closings and provides data and analysis for all payers.
  • Communicates with the utilization review department regarding authorizations issues and inquiries.
  • Completes necessary processes for adjustments, write-offs, charity care and refunds.
  • Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.
  • Maintains interdepartmental reports for patient accounts and collections.
  • Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
  • Assists in the FY audits.
  • Communicates with the Medical Records department for applicable data required for patient appeals and denials.
  • Works on special projects as needed.
  • Attends mandatory Gateway training and in-services.
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