Job Type
Full-time
Description
If you’re detail-oriented, passionate about accuracy, and thrive in a fast-paced environment, we want to hear from you!
Gateway Rehab Center (GRC) has an outstanding opportunity for a remote Billing Specialist 1 who will be responsible for the billing of patient services, performing follow-up on outstanding accounts receivable, processing refunds, patient denials and write-offs. This position receives infrequent supervision and instruction from the Manager of Billing Services.
Note: This is a remote position. You MUST live in the Pittsburgh, PA Region!
Responsibilities
- Processes, edits, audits and posts service entries into the EHR.
- Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
- Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
- Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
- Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
- Participates in the monthly closings and provides data and analysis for all payers.
- Communicates with the utilization review department regarding authorizations issues and inquires.
- Completes necessary processes for adjustments, write-offs, charity care and refunds.
- Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.
- Maintains interdepartmental reports for patient accounts and collections.
- Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
- Assists in the FY audits.
- Communicates with the Medical Records department for applicable data required for patient appeals and denials.
- Works on special projects as needed.
- Attends mandatory Gateway training and in-services.
Knowledge, Skills, and Abilities
- Understanding of healthcare billing practices
- Familiarity with commercial insurance providers, including prior authorizations and claim submissions.
- Knowledge of the full billing cycle, including charge entry, claims processing, payment posting, and collections.
- Knowledge of basic accounting principles.
- Understanding of patient privacy laws and healthcare compliance standards.
Requirements
- High School diploma or equivalent required.
- Minimum of one year billing experience.
Other Requirements
- Pass a PA Criminal Background Check
- Obtain PA Child Abuse and FBI Fingerprinting Clearances
- Pass Drug Screen
- TB Test
Work Conditions
- Favorable working conditions.
- Minimal physical demands.
- Significant mental demands include routine decision making, continuous attention to detail and high mental and visual concentration.
- Accuracy is critical in this position as errors may result in serious loss of revenue and delay of payments.
GRC IS AN EQUAL OPPORTUNITY EMPLOYER M/F/D/V
