Revenue Cycle Specialist / AR Specialist / Medical Biller

About the Role

This position requires the candidate to reside within the Central Time Zone.

Key Responsibilities

• Submit timely, accurate invoices to payers for products and services.
• Understand contract terms and fee schedules.
• Determine correct quantities and prices for drugs billed.
• Verify services and products are authorized and required documentation is on file.
• Ensure invoices are submitted for properly ordered and confirmed services/products.
• Evaluate received payments for correctness and apply them accurately to the system.
• Verify payments are correct according to the fee schedule.
• Apply payments correctly to patient accounts.
• Mail secondary bills and patient invoices within 48 hours of payment receipt.
• Notify the Reimbursement Manager of overpayments or duplicate payments.
• Transfer payments belonging to other offices within 48 hours of receipt.
• Follow up on submitted invoices to ensure prompt payment.
• Verify claim receipt and processing status.
• Send letters to patients or responsible parties for unpaid insurance claims.
• Generate and mail statements and collections letters.
• Follow up on all denials within 48 hours of receipt.
• Ensure compliance with contract terms and fee schedule policies.
• Follow HIPAA guidelines for patient information confidentiality.

Requirements & Tech Stack

• Microsoft Excel (Basic Level: opening workbooks, inserting rows/columns, selecting font style/size, formatting cells as currency, using copy/paste/save, aligning text, selecting cells, renaming worksheets, selecting chart styles, inserting worksheets, setting margins, selecting page orientation, using spell check, printing worksheets).
• Microsoft Word (Basic Level: opening documents, cutting/pasting/aligning text, selecting font type/size, changing margins/column width, sorting, inserting bullets/pictures/dates, using find and replace, undo, spell check, track changes, review pane, print functions).

Qualifications

• High School Diploma or equivalent.
• 6 months previous Infusion Reimbursement or Intake/Admissions experience.