Sr. Billing Specialist
About The Position
The revenue cycle doesn't run on optimism — it runs on discipline, deep payer knowledge, and someone who leads from the front when accounts get complex, denials get ugly, and the team needs a higher standard to rise toward. As the Senior Billing Specialist at Rebis Health, you own the hardest problems in our A/R, run our biweekly collections placement process, set the bar for team quality through hands-on QA and coaching, and build the systems that make everyone around you more effective. ABOUT REBIS HEALTH Rebis is a multidisciplinary sleep wellness center dedicated to transforming sleep health and restoring overall wellness. Our name represents the sacred union of healing disciplines, bringing together diverse expertise into a unified system of care designed to help individuals heal and thrive. Our mission is to restore and enhance individual healing by optimizing sleep health through a collaborative, compassionate, and highly coordinated approach. Our vision is to become the nation’s leading multidisciplinary center for sleep wellness, setting a new standard for both care and experience. At the heart of Rebis is a simple commitment: Every person who interacts with us should feel Loved, Heard, and Safe. We work in a culture grounded in integrity, service, and genuine curiosity — where the unglamorous work of billing and operations is understood as essential to the healing we provide. We move with purpose, take pride in precision, and believe that a well-run back office is how patients trust us with their care. Why This Role Matters When the toughest billing challenges arise, they land with you. Your expertise turns stalled accounts into recovered revenue, helping sustain the programs and care our patients depend on. Beyond individual wins, you strengthen the entire team—building better processes, sharing knowledge, and raising performance across the board. You don’t just resolve complex accounts; you help others succeed with them.
Requirements
- 3–5+ years of progressive medical billing experience.
- Experience with complex denial management.
- Experience with A/R aging strategy.
- Experience with appeals for Medicare, managed care, or commercial payers.
- Demonstrated success running a payer portfolio to net collection benchmarks.
- Strong Athenahealth experience.
- Experience with collections placement (TSI or similar agencies).
- History of coaching or QA-ing other billers, formally or informally.
- Deep knowledge of payer behavior on appeals and escalation leverage points.
- Rigorous about documentation.
- Ability to share knowledge, audit work honestly, and address recurring mistakes.
Nice To Haves
- Experience in Sleep Medicine, DME, neurology, pulmonology, or complex specialty outpatient billing.
- Experience building payer playbooks or denial root cause programs from scratch.
- Ability to track personal KPIs (A/R performance, appeal win rates, denial trends) and discuss them in an interview.
Responsibilities
- Manage assigned accounts with at least 2.0 touches per week, aiming to reduce the 90+ day A/R bucket by at least 70% and the 120+ bucket by at least 50%, with a documented next step on every touch.
- Handle high-complexity denial mixes, including major payer disputes, escalations, and Medicare and managed care situations, maintaining a 14-day rework rate below 12%. Document every account outcome (rebill, appeal, escalate, or close).
- Ensure at least 98% of appeal packets are sent within 3 business days of readiness, meeting Medicare audit standards for quality. Track overturn rates quarterly by denial category and use data to improve win rates.
- Achieve net collection benchmarks for assigned payer accounts and maintain payer playbooks. Proactively address trending preventable denial categories at their source.
- Review high-dollar accounts weekly, actioning them and sending escalations with full documentation within 2 business days. Build recovery plans for timely filing risk and recoupment exposure.
- Review all eligible accounts against TSI and Phone Collections criteria biweekly, submitting qualifying placements with a ≤2% exception rate. Ensure Athenahealth documentation is complete before placement.
- Conduct at least 2 formal root cause analyses per month for recurring denials, routing corrective actions to responsible owners and verifying fix adoption within 10 business days.
- Perform biweekly QA audits on Level I and II work, conduct documented coaching sessions, and aim for a ≥90% audit pass rate after each coaching cycle.
- Escalate payer issues with complete evidence within 5 business days, maintaining a follow-up cadence until resolution and providing leadership with trend visibility.
Benefits
- 401(k)
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Unlimited PTO plus Paid Federal Holidays
- Complimentary Rebis Health Care Access to support your personal health
- Parental Leave
- Hybrid Work Eligibility (after demonstrating competency and trust, determined by performance)
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
