Medical Billing Specialist
About The Position
The Medical Billing Specialist manages third-party billing across WesleyLife branches, ensuring claims are submitted accurately and on time. The role maintains knowledge of Medicare and skilled billing regulations and implements process changes as needed for compliance. It also involves Medicare and commercial insurance knowledge for co-insurance calculations, cash posting, and collections; handling delinquent accounts and credit balances; and maintaining the confidentiality of client and organizational information. The specialist updates HCPC and RUG rates, PDPM, and billing software tables. They coordinate with office managers, therapy providers, directors of nursing, providers, finance staff, auditors, and state agencies to support accurate billing and smooth operations. The role includes communicating with clients, responsible parties, and therapy providers about charges and financial information, participating in projects, collaborating with team members, and performing other duties as assigned.
Requirements
- 4–5 years of healthcare billing experience.
- Ability to manage multiple functions and schedules under pressure amid changing priorities.
- Strong organizational skills and ability to meet billing deadlines.
- Excellent verbal and written communication skills with clients, vendors, and team members.
- Professional work ethic, attitude, and etiquette.
- Ability to collaborate with internal and external resources while maintaining confidentiality.
- Attention to detail and ability to work well in a team-oriented environment.
- Strong problem-solving abilities, including resolving challenges independently and collaboratively.
Responsibilities
- Manage third-party billing across all WesleyLife branches and ensure claims are submitted accurately and on time.
- Stay current on Medicare and skilled billing regulations and implement necessary compliance process changes.
- Apply knowledge of Medicare and commercial insurance to co-insurance calculations, cash posting, and collections.
- Handle delinquent accounts and resolve credit balances.
- Maintain confidentiality of client and organizational information.
- Collaborate with providers, finance staff, auditors, and state agencies.
- Update HCPC and RUG rates, PDPM, and billing software tables.
- Coordinate with office managers, therapy providers, and directors of nursing to ensure accurate billing and streamline operations.
- Communicate with clients, responsible parties, and therapy providers about charges and financial information.
- Perform other assigned duties, participate in projects, and collaborate effectively with team members.
Benefits
- Comprehensive benefits package including health care, vision, dental, and 401(k).
- Discounted wellness center memberships and cash incentives for healthy habits.
- Voluntary life, accident, and critical illness coverage.
- Scholarship assistance up to $3,000 per year.
- Tuition reimbursement up to $1,500 per year.
- Educational discounts: 18% off tuition at Purdue University Global.
- Ongoing leadership training and development pathways.
- Referral bonus program.
- Recognition and appreciation programs.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
