Revenue Cycle Billing Specialist

Mountain Area Health Education Center - MAHEC•Asheville, NC

10d•Onsite

About The Position

Manage daily billing functions for assigned patients and insurance companies, coordinating interactions between patients and payors to facilitate timely reimbursement. Serve as a point of contact for billing problem solving, with in-depth knowledge of carrier Clinical Coverage Policies (CCP) and Billing Coverage Policies (BCP). The role involves maintaining billing and collection performance metrics, resolving claims and account issues, posting and balancing payment activity, processing claims and reports, and responding to billing inquiries. Maintain patient confidentiality and ensure compliance with HIPAA regulations. This is a full-time, on-site position with typical business hours Monday through Friday, 8:00 a.m. to 5:00 p.m., or hours flexed to meet client or division needs. The workweek is 40 hours. Weekend, holiday, or evening coverage is occasionally required, and hours may need to be flexible for special assignments or evening activities requested by the team leader. Regular on-site attendance is an essential function. The position pays $23.65 per hour, with full benefits available. MAHEC is a qualifying employer for the Public Service Loan Forgiveness program; eligible employees may qualify for loan forgiveness after 10 years of qualifying payments while working full-time. All MAHEC employees and learners must receive the flu vaccine or have an approved exemption. MAHEC does not provide employment-based U.S. visa sponsorship.

Requirements

Associate degree in Business, Health Administration, or a related field, and three years of relevant experience in dental; or a comparable combination of education and/or experience.
Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint.
Ability to use or learn Allscripts products and various insurance company websites.
Ability to communicate clearly and respectfully with colleagues, patients, and family members, including in complex or difficult situations.
Ability to make appropriate decisions, resolve conflicts, think critically, prioritize work, and ensure timely completion of tasks.
Ability to keep healthcare knowledge current, meet applicable licensure and annual training requirements, and apply relevant knowledge in practice.
Professionalism, empathy, effective listening, dependability, and interpersonal skills when working with colleagues, patients, and families.
Ability to work autonomously and analytically to solve complex problems and support continuous improvement.
Ability to adhere to organizational values, including integrity, accountability, respect for other cultures, equitable practices, and adaptability.
Ability to meet the stated physical demands: lift a 10-pound box overhead, lift and carry 15 pounds, and push or pull a 20-pound cart occasionally (0–33% of the workday).
Regular on-site attendance and flexibility to respond to special assignments or evening activities are required.

Nice To Haves

Spanish-speaking skills are preferred.

Responsibilities

Manage daily billing functions for assigned patients and insurance companies.
Coordinate interactions between patients and payors to facilitate timely reimbursement and serve as a point of contact for billing problem solving.
Maintain Accounts Receivable KPI, with balances older than 120 days below 19% of total A/R.
Maintain Adjusted Collection Percentage KPI, with reimbursement/collections at or above 97% of expected.
Review and resolve denied patient insurance claims and collection accounts.
Process patient refunds and manage online payment portals.
Assist in identifying current or potential billing issues related to unpaid claims.
Post and balance carrier remit activity, including payments, contractual adjustments, and other adjustments.
Post and balance patient payments.
Make appropriate decisions and contact carriers to maximize reimbursement on accounts being worked.
Correct errors on electronic error reports.
Process and print or transmit patient insurance claims, bills, and other reports.
Respond to patient account inquiries in person, by phone, or by mail, and resolve problems as necessary.
Respond to office staff inquiries regarding patient charges, appropriate diagnosis coding, and insurance coverage issues.
Respond to employee, payer, and patient inquiries regarding CPT and ICD-10 codes.
Maintain a high level of patient confidentiality and ensure compliance with HIPAA regulations.
Attend work regularly on-site and provide occasional weekend, holiday, or evening coverage as required.