Medical Accounts Receivable Billing Specialist

WACBD - Washington Center for Bleeding Disorders•Seattle, WA

7d•$23 - $31

About The Position

The Medical Accounts Receivable Billing Specialist reports directly to the Revenue Cycle Manager and manages and resolves insurance and patient accounts receivable. The role ensures accurate and timely billing, reimbursement, and collections, supporting WACBD’s financial health by monitoring outstanding balances, communicating with patients and payers, and maintaining documentation in accordance with organizational policies and healthcare regulations. It requires strong analytical skills, attention to detail, and a commitment to exceptional service for patients with chronic and complex medical needs. The position is full-time, Monday–Friday. Hybrid or remote options are available based on department policy. The employee may sit or stand at a workspace while using a computer and telephone, and may work occasional overtime during month-end close or audits.

Requirements

At least 2 years of hands-on medical billing and accounts receivable experience managing claim follow-up, denials, appeals, and payment posting, with certification; alternatively, at least 5 years of hands-on experience in these areas in lieu of certification.
In-depth knowledge of medical terminology, CPT, ICD-10, and HCPS coding principles.
Proficiency with clearinghouses and payer portals.
Demonstrated success improving accounts receivable metrics, such as reducing DSO or increasing first-pass yield.
Strong understanding of payer policies, guidelines, and regulations for commercial, government (CMS), and third-party payers.
Strong analytical, problem-solving, and written communication skills, including the ability to craft effective appeals with supporting documentation.
Prior experience with Microsoft Office, EHR, and practice management systems.
High degree of integrity, professionalism, and ethical conduct.
Commitment to maintaining strict patient confidentiality and adhering to HIPAA regulations.
Excellent written and verbal communication skills, with the ability to articulate complex information clearly and concisely.
Ability to cultivate diversity and respect.

Nice To Haves

340B pharmacy billing experience.
Active CPC, CPC-A, CPB, or CRCR certification.
Associate degree or higher in business, finance, or healthcare-related studies.
Prior EHR experience with NextGen, R2, Newleaf/Keycentrix, or related pharmacy billing software.

Responsibilities

Review and monitor accounts receivable aging reports to identify outstanding balances and prioritize follow-up activities.
Work complex denials involving coding, medical necessity, eligibility, prior authorization, duplicate claims, bundling, and coordination of benefits; submit appeals to secure reimbursement.
Contact insurance companies to verify claim status, resolve payment issues, and request claim reprocessing when necessary.
Post, reconcile, and verify insurance payments accurately.
Communicate with patients regarding insurance eligibility, out-of-pocket costs, and benefits.
Reconcile remittance advice (ERA/EOB), post payments and adjustments, resolve underpayments and overpayments, and escalate variances.
Collaborate with internal departments to resolve billing and reimbursement issues.
Partner with management to discuss and report on trends in denials, performance, and insurance payers.
Maintain detailed and accurate records of account activity, follow-up efforts, and correspondence in the billing system.
Collaborate with Revenue Integrity/Coding to correct charge capture and coding issues, and contribute to process improvements and SOP updates.