Medical Billing Specialist

Reporting to the Director of Healthcare Revenue Cycle Management, the Billing Specialist will handle all functions related to the collection of necessary claim documentation, claim submission, collections, and follow through on outstanding claims and cash applications. This individual will process all transactions relating to delinquent accounts, special adjustments, and/or write-offs, ensuring a smooth and accurate billing process. This individual will also lead regular cross functional meetings regarding consumer liability accounts, resolving billing and payment issues as needed.

• Gather all information necessary to process consumer insurance claims; ensure billing accounts, patient demographic and insurance information are set up and entered accurately
• Prepare and analyze reports, ensuring billing deadlines are met; identify root causes of the claims not being paid on time
• Lead meetings with cross-functional teams regarding consumer liability accounts; resolve billing and payment issues as needed
• Monitor, track, and report on self-pay balances using the billing system; identify issues, and recommend necessary actions
• Post 835 payment files to the billing system and edit any unmatched payments to post
• Research and resolve billing discrepancies; resubmit rejected and denied claims if necessary, working with payers to resolve outstanding claims issues as needed
• Audit file submissions and work through any variances, collaborate with management team as needed
• Perform other duties as assigned

• 3-5 years in medical billing field; Knowledge/experience working with billing and payment cycles for medical accounts and analyzing accounts receivable reports is strongly desired
• Strong data entry skills required; must possess exceptional attention to detail and prioritization skills
• Working knowledge of insurance processes and terminology, including an understanding of EOBs, copays, coinsurance, deductibles, spenddowns, denial codes, and cost shares
• Experience working with Medicaid, private insurance, insurance verification, authorization and reimbursement preferred
• Strong organizational, communication and analytical skills
• Proficient in MS Office (particularly Excel) and medical billing software, with ability to work across multiple spreadsheets and systems
• Ability to multi-task in a changing and fast paced environment

At Careforth your well-being matters. With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our benefits are designed to help you thrive, both professionally and personally. Discover how we invest in you: https://careforth.com/careers/#benefits

The pay range for this position is $40,560 - $56,784 OR 19.50 - 27.30/hr.

The actual wage offered may be lower or higher depending on budget and candidate experience, knowledge, skills, qualifications, and geographic location.

#LI-Remote (Role is remote; however, we are unable to hire candidates residing in California)