Billing Specialist

Job Description

Our client, a leader in the public-sector healthcare space, is seeking a Billing Specialist to manage complex accounts receivable follow-up and resolve outstanding healthcare claims to ensure timely and accurate reimbursement. This role involves researching claim denials, rejections, and unpaid claims, communicating with insurance payers, and submitting appeals when appropriate.

Responsibilities:

Extensive Accounts Receivable Follow Up (healthcare claims)

• Claims Research (denials, rejections, no response claims)
• Resolve denial, rejection and no response claims
• Contact payers and research outstanding claims
• File appeals when appropriate
• Use of tools such as payer portals, clearinghouse, payment policies, online payer manuals
• File appeals when appropriate
• Ability to work within a clearinghouse to resolve claim issues (TriZetto a plus)
• Posting payments/denials

Required Skills:

• Strong organizational, quantitative and analytical skills
• Demonstrated accuracy with a strong attention to detail
• Excellent work ethic and ability to prioritize tasks
• Detailed and process improvement oriented
• Excellent problem-solving skills
• Ability to present findings and discuss issues with supervisor effectively
• Ability to work independently and as a part of a team in a deliverable-focused professional environment
• Ability to shift focus as necessary when priorities change without losing sight of original assignments
• Experience in third party practice management systems, and excel

Qualifications:

• High School diploma or equivalent
• 5 plus years’ relevant experience