Specialist, Billing

Revology

1d•Remote

About The Position

The Billing Specialist role is responsible for ensuring the accurate and timely submission of claims, with a focus on identifying, correcting, and preventing billing edits and claim rejections, as well as resolving insurance balances and ensuring accurate and prompt reimbursement. This role is essential to achieving high clean-claim rates and minimizing denials and payment delays for our clients. An effective Billing Specialist is a detail-oriented problem solver, and thrives in a dynamic, fast-paced environment.

Requirements

3+ years of healthcare billing and insurance experience required.
Ability to work independently to accomplish goals in a dynamic environment.
High school diploma or equivalent required.
An aptitude for problem-solving, patience and flexibility while working in the complex industry of healthcare revenue cycle.
Excellent attention to detail.
Ability to comfortably navigate a technology-focused setup to efficiently complete assigned work (multiple monitors + several applications open simultaneously).
Must be legally authorized to work in the United States without sponsorship.

Nice To Haves

Experience with claim clearinghouses (Waystar, Availity, Change Healthcare, etc.) highly preferred.
bachelor’s degree or equivalent experience preferred.

Responsibilities

Resolve and/or remedy claim errors, edits and rejections to ensure proper and timely submission to payers.
Monitor assigned reports and worklists within the patient accounting system, clearinghouse, and/or payer portals, promptly identifying and resolving claim edits and rejections with accuracy and efficiency.
Follow up with insurance companies regarding the status of outstanding claims and pursue appropriate steps for remedy.
Review and respond to insurance correspondence as needed to ensure complete and accurate reimbursement.
Identify and escalate trends to leadership to support process improvement, clean-claim performance, and optimize reimbursement.
Maintain strong working knowledge of payer guidelines, billing rules, and relevant regulatory requirements applicable to assigned work.
Consistently meet or exceed established productivity and quality standards.
Effectively navigate multiple computer systems and applications simultaneously; documenting all actions taken in Revology and / or client platforms in accordance with operational protocols.
Comply with and hold with utmost regard all compliance requirements to protect patient privacy and confidentiality.
Stay curious, kind and contribute positively to the Revology culture. The health + harmony of the team is everybody’s responsibility at Revology.