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Beacon Health System · 1 week ago

Billing Specialist Rep (Remote)

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

Beacon Health System is dedicated to delivering outstanding care and inspiring health. The Billing Specialist Representative is responsible for securing timely and accurate reimbursement by resolving billing issues with commercial and government payers, requiring strong analytical skills and a proactive mindset.

FitnessHealth Care

Responsibilities

Submit timely and accurate claims (UB-04/CMS-1500) to payers, ensuring compliance with regulatory and payer-specific requirements

Work claim edits and correct errors in demographic, insurance, and charge data to ensure clean claim submission

Conduct prompt and thorough follow-up on outstanding receivables, including appeals and disputes for denials and underpayments

Identify and resolve payer overpayments in a timely manner to ensure regulatory compliance and prevent future recoupments

Analyze denial reasons and payment variances to identify root causes and recommend process improvements

Maintain in-depth knowledge of payer guidelines and federal/state regulations

Collaborate with payers and internal departments to resolve issues and achieve account resolution

Accurately document all actions and communications in the billing system

Review patient accounts for accuracy in demographics, insurance coverage, and billing details

Identify patterns or trends in denials and reimbursement discrepancies

Assist leadership in developing denial prevention strategies and performance improvement initiatives

Prioritize and escalate high-risk accounts for timely resolution

Demonstrate initiative in recommending improvements to workflow and system efficiency

Maintain compliance with HIPAA and all applicable billing regulations

Respond to payer communications via phone, portal, and email in a professional and timely manner

Collaborate across teams to ensure coordinated resolution of account issues

Communicate effectively with patients, coworkers, and external partners, always maintaining professionalism and respect

Completing other job-related assignments and special projects as directed

Attends and participates in department meetings and is accountable for all information shared

Completes mandatory education, annual competencies and department specific education within established timeframes

Completes annual employee health requirements within established timeframes

Maintains license/certification, registration in good standing throughout fiscal year

Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department

Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self

Adheres to regulatory agency requirements, survey process and compliance

Complies with established organization and department policies

Available to work overtime in addition to working additional or other shifts and schedules when required

Qualification

Insurance billing experienceUB-04/CMS-1500 knowledgeAnalytical skillsMicrosoft 365 proficiencyProblem-solving skillsEffective communicationOrganizational skillsCritical thinkingAdaptability

Required

Strong critical thinking and analytical skills to identify denial trends, address payment variances, and pursue appropriate corrective actions

Proactive, problem-solving mindset and the ability to adapt in a fast-paced, evolving environment