Billing Specialist

Job description

The Billing Specialist is responsible for performing specified financial tasks in support of the day-to-day operations of the Billing/Revenue Cycle Department.  We’re looking for someone with a strong internal drive to solve problems, drive collections, is a team player, and ensure every claim is handled with care and urgency.

Following training, this will be a hybrid position offering the opportunity to work 3 days in the office and 2 days remotely each week.

Position Responsibilities may include, but not limited to - Create billing reports of assigned agencies - Submit accounts receivable claims and/or invoices for weekly/monthly billing of assigned agencies - Reconciliation of assigned state or local agencies - Research and resubmit of billings to assigned agencies - Review quality assurance of all referrals or updated clients from assigned state or local agencies - Make outbound & inbound calls, emails to assigned state or local agencies with the purpose of securing correct information regarding new referrals, updated clients, and billings - Responsible for executing complex billing tasks, mentoring junior staff, and leading cross-functional initiatives - Reduce payment agency backlog - Perform in-depth audits of project data to identify and resolve billing discrepancies - Demonstrate successful performance through accuracy, timeliness, and customer satisfaction metrics - Utilize advanced Excel functions (e.g., VLOOKUP) and reporting tools in CRM and SharePoint - Manage complex billing scenarios including denials, rejections, and aging accounts - Collaborate with Posting teams to resolve discrepancies and support month-end close - Prepare and submit electronic claims, paper claims, and invoices (CMS-1500, UBs, invoices, and payer portals, etc.) - Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans - Ensure accurate and compliant billing, following specific regulations of multi-state Medicaid and MCO's, Medicare Advantage, and Older Americans Act programs - Responsible for ensuring aged outstanding balances of assigned payers is kept within department standards - Participate in process improvement initiatives. Collaborate across teams to resolve issues, claims denials, and aging - Other tasks as assigned, including but not limited to, assisting with projects that impact collections or write offs

Required Skills and Experience - High School Diploma or GED - 2+ years of work-related experience in healthcare related field, ie, healthcare billing institutional and professional claims, patient registration, and/or patient access - Intermediate level Excel skills - Strong oral and written communication skills - Ability to multi-task, set priorities, and pays close attention to detail - Strong ability to work with team members across multiple departments - Ability to work unsupervised with strong critical thinking and problem-solving skills        - Experience with Waystar, CRM, D365, and/or electronic health record platforms - Must have a wired internet connection using an ethernet port. Broadband internet wired to the home is required - Cable Modem/service or Fiber Optic. No Satellite, 4/5G, or DSL circuits - Must have a quiet workspace that is free from distraction

Preferred Skills and Experience - Bachelor's degree in healthcare administration, medical administrative assistance, or healthcare finance - Previous experience with electronic claims, such as electronic 835/837 claim and remit files, Zirmed, and/or secure payer web portals - AAHAM and/or HFMA certification - Knowledge of CMS regulation and strong familiarity with healthcare billing standards and compliance - Experience with Waystar, CRM, D365, and/or electronic health record platforms

Physical Requirements - Repetitive motions that include the wrists, hands and/or fingers - Sedentary work that primarily involves sitting, remaining in a stationary position for prolonged periods - Visual perception to perform job including peripheral vision, depth perception, and the ability to adjust focus

Company Overview

Mom’s Meals is a home-delivered meal service providing fully prepared, refrigerated meal solutions direct to homes nationwide since 1999. We provide seniors, patients recovering post-discharge and those managing a chronic condition with tailored nutrition solutions to manage their specific needs. If you are passionate about the well-being of others and have a strong sense of community, Mom’s Meals could be the place for you! We are a family operated business looking for fun, compassionate, and friendly people who want to make a difference in the lives of others.

EEO

Mom’s Meals complies with all applicable federal and state non-discrimination laws. All qualified applicants shall receive consideration for employment without regards to race, religion, national origin, ancestry, color, gender, age, disability, sexual orientation or military status.