Regional Billing Specialist

PACSRemote - Ohio, OH
$80,000 - $100,000Onsite

About The Position

The Regional Billing Specialist is responsible for ensuring the accuracy, integrity, and efficiency of accounts receivable processes across the designated region. This role serves as a technical expert and oversight mechanism to maximize collections and minimize aging through proactive claims management and adherence to payer regulations.

Requirements

  • 2–4 years of experience in healthcare billing, accounts receivable, or revenue cycle operations.
  • Working knowledge of payer rules, billing regulations, and claims submission processes.
  • Experience with electronic health record (EHR) and billing platforms (PointClickCare or similar).
  • Strong analytical skills with the ability to identify trends, resolve billing issues, and ensure data integrity.
  • Excellent attention to detail, documentation habits, and organizational skills.
  • Ability to communicate effectively with Business Office Managers, payers, and cross-functional teams.
  • Advanced knowledge of PointClickCare and Waystar (or similar clearinghouses).
  • Demonstrate high levels of autonomy, organization, and assertiveness when addressing billing discrepancies.
  • Exhibit flexibility and a cooperative spirit in a fast-paced, multi-facility environment.

Responsibilities

  • Generate trial claims regularly to identify and resolve billing errors prior to final submission.
  • Ensure all prior-month claims are billed immediately following the Triple Check date.
  • Maintain a cumulative list of all unbilled claims; provide daily updates and documentation until all prior-month claims are successfully released.
  • Review Waystar for rejected claims daily. Ensure all rejections are corrected and resubmitted within one business day.
  • Maintain comprehensive working knowledge of payer contracts and rules; ensure all billing aligns strictly with specific contract provisions.
  • Review Payer Setup Information reports regularly to identify inaccuracies. Execute corrections or direct Business Office Managers to resolve errors via the collection note process.
  • Monitor insurance portals for status updates and denials. Execute immediate corrections or submit formal appeals as appropriate to secure payment.
  • Monitor the PointClickCare Upcoming Activity Tab. Review outstanding accounts, initiate new activities, and provide direct feedback/notes to BOMs within the module.
  • Ensure detailed, professional notes are added to all accounts worked within PCC to maintain a clear audit trail.
  • Post all payer-appropriate cash to PCC daily. Perform regular reconciliations between bank deposits and PCC postings to ensure financial data integrity.
  • Analyze accounts receivable aging reports to identify negative trends or systemic issues.
  • Keep executive leadership informed by providing concise summaries and actionable insights regarding the region's financial health.
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