Full-Time Accounts Receivable/Medical Billing Specialist

PH Workforce Delivering to USMedCore Solutions, the healthcare division of Bizforce, is looking for an experienced Accounts Receivable (AR) Specialist with expertise in Hospital Billing experience to join our team.

The ideal candidate will be responsible for handling the full spectrum of billing and accounts receivable processes, with a strong focus on hospital medical bill audits. Proficiency in Epic Systems is required.

Key Responsibilities:

1. Billing and Claims Management: Prepare, review, and submit claims for procedures. Monitor and ensure accuracy in claim submissions and compliance with payer requirements. Review and audit hospital medical bills to ensure accuracy and compliance with payer requirements.
2. Accounts Receivable Tracking: Track and manage outstanding accounts receivable to ensure timely payments. Follow up with insurance companies and patients to resolve unpaid claims and balances.
3. Denial Management: Identify, research, and resolve claim denials or underpayments related to Ambulatory/Emergency services. Coordinate with coding and billing teams to rectify issues and resubmit claims.
4. Reconciliations: Reconcile payments, adjustments, and account balances to maintain accurate financial records. Ensure all accounts are accurately updated in the system.
5. Reporting: Generate AR aging reports and provide insights into trends and challenges in payment cycles. Contribute to monthly financial reporting for leadership review.
6. Compliance: Stay updated on payer policies, coding guidelines, and Ambulatory/Emergency billing regulations. Ensure compliance with HIPAA and organizational policies.

Requirements:

• Minimum 3 years of experience in AR management, with at least 2 years in Hospital billing.
• Extensive experience in hospital medical bill audits.
• Proficient in Epic Systems for billing, claims, and AR workflows.
• Excellent analytical and problem-solving skills.
• Exceptional attention to detail and organizational abilities.
• Effective communication and negotiation skills for resolving payment issues.
• Willing to work in a graveyard shift (US time zone)

Key Results

• Reduce coding and billing error rate
• Achieve the target collections goals set and collections status report
• Reduced number of denials and complaints
• Achieve an accuracy rate of 99%
• Utilization of billing and coding software programs

System Requirements

• Candidates must have the following on their device (Desktop or Laptop):
• Processor: Either Intel Core i5 and up or AMD Ryzen 5 and Up
• RAM: 8GB and up
• OS: Windows 11 Pro (Windows 10 Pro is acceptable but not preferred). OS should be a legit license
• Internet Connectivity: At least 50 Mbps and should be wired
• Back-up connection and Power Supply
• Hard Disk: At least an SSD
• For Mac: Processor - Apple M1 chip
• RAM: 8GB and up

Benefits

• Permanent Work From Home
• Weekly Paychecks
• Fixed Weekends Off
• Great Company Culture and No Micromanagement
• Thriving Company Culture with Complete Autonomy

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