Accounts Receivable Specialist - Medical Billing

We are seeking an experienced Accounts Receivable Specialist to join our team. This role is fully onsite and requires strong knowledge of medical billing, coding, and payer processes. The ideal candidate has proven expertise in accounts receivable within a healthcare setting, with specific experience in behavioral health.

Qualifications

• Minimum of 3 years of accounts receivable experience in medical billing.

• At least 1 year of experience in the behavioral health industry.

• Proficiency with UB04, CMS 1500, CPT, HCPCS, and ICD-10 coding.

• Demonstrated understanding of medical terminology and billing/collection practices.

• Experience with payment posting and payer portals.

• Strong skills working with EHR/EMR or healthcare-related systems.

• Advanced Microsoft Excel skills required.

Key Skills

• Knowledge of industry regulations and proper claims submission processes for government and commercial payers.

• Ability to review and appeal denied or unpaid claims.

• Strong critical thinking and problem-solving skills.

• Excellent written and verbal communication skills; comfortable presenting information.

• Highly organized, detail-oriented, and able to prioritize tasks in a fast-paced environment.

• Ability to work independently while meeting deadlines.

Responsibilities

• Verify patient insurance coverage and payer authorizations.

• Collect and validate information needed to create accurate claims.

• Submit, monitor, and follow up on claims with insurance companies, providers, and patients.

• Post payments across multiple business units and systems, including manual and electronic remittance advices.

• Review remittance advices to identify denial trends and escalate payer issues when needed.

• Perform ongoing monitoring of accounts to ensure maximization of collections.

• Research and adhere to payer-specific, state, and federal billing and collection guidelines.

• Maintain accurate medical billing files and accounts receivable reports.

• Apply contractual, patient, and other adjustments to accounts as appropriate.

• Participate in special projects and support team initiatives as assigned.

• Ensure compliance with HIPAA guidelines and industry standards.