Healthrise · 1 week ago
Billing Representative
United States
Full-time
Remote
Entry, Mid Level
2+ years expHealthrise is a company focused on revenue cycle management, and they are seeking a Billing Representative to perform day-to-day billing activities for Hospital and Medical Group claims. The role involves ensuring timely, accurate, and compliant billing operations, resolving billing issues, and maintaining knowledge of relevant laws and regulations.
Financial Services
Responsibilities
Demonstrates knowledge of and commitment to the Healthrise Core Values
Performs daily billing activities, including resolving billing edits and rejected claims to ensure accurate and timely claim submission
Identifies routine billing issues and resolves or escalates them as appropriate
Maintains working knowledge of state and federal laws related to insurance contracts and payer billing timelines
Investigates and addresses overpayment and underpayment accounts to optimize reimbursement
Applies payer rules, contracts, schedules, and related data to ensure claims are billed accurately and timely
Researches payer trends and provides feedback to improve billing accuracy and operational efficiency
Tracks and reports denial types and root causes, recommending process improvements
Analyzes, categorizes, and resolves claim rejections from commercial, government, and managed care payers
Documents all actions and follow-up activities in the patient accounting system
Responds to patient and payer inquiries or refers them appropriately
Prepares and submits reports documenting billing trends, outcomes, and claim activity
Interprets data, draws conclusions, and reviews findings with supervisor
Cross-trains in various functions to enhance service delivery
Maintains knowledge of applicable federal, state, and local laws and regulations
Performs other duties as assigned
Qualification
Required
High school diploma or Associate degree in Accounting, Business Administration, or a related field
Minimum of two (2) to three (3) years of experience in revenue cycle medical billing, insurance follow-up, and denial management within one of the following settings: Hospital or clinic, Health insurance company or managed care organization, Healthcare financial services environment
Equivalent combination of education and experience may be considered
Experience in a complex, multi-site healthcare system preferred
Excellent written and verbal communication skills
Strong organizational and time-management skills with high attention to detail and accuracy
Strong interpersonal and customer service skills
Basic proficiency in Microsoft Office (Outlook, Word, PowerPoint, Excel)
Completion of regulatory and mandatory certifications preferred
Comfortable working in a collaborative, shared-leadership environment
Previous experience with Global Partner vendors preferred
Experience using Epic
Familiarity with CPT, ICD-10, and HCPCS coding
Strong problem-solving skills
Ability to work independently, meet deadlines, and maintain high attention to detail
Preferred
Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or equivalent certification
Company
Healthrise
Hospital systems are not all created equal. So one-size-fits-all solutions don’t work. At Healthrise, we customize solutions to meet your needs.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
David Farbman
CEO
Ryan McKindles
Co-Founder / President
Recent News
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