Position Summary The Billing Specialist is responsible for performing specified financial tasks in support of the day-to-day operations of the Billing / Revenue Cycle Department.Were looking for someone with a strong internal drive to solve problems, drive collections, is a team player, and ensure every claim is handled with care and urgency.
PTO and benefits available after 30 days of employment. Following training, this will be a hybrid position offering the opportunity to work 3 days in the office and 2 days remotely each week. Position Responsibilities may include, but not limited to
- Create billing reports of assigned agencies
- Submit accounts receivable claims and / or invoices for weekly / monthly billing of assigned agencies
- Reconciliation of assigned state or local agencies
- Research and resubmit of billings to assigned agencies
- Review quality assurance of all referrals or updated clients from assigned state or local agencies
- Make outbound & inbound calls, emails to assigned state or local agencies with the purpose of securing correct information regarding new referrals, updated clients, and billings
- Responsible for executing complex billing tasks, mentoring junior staff, and leading cross-functional initiatives
- Reduce payment agency backlog
- Perform in-depth audits of project data to identify and resolve billing discrepancies
- Demonstrate successful performance through accuracy, timeliness, and customer satisfaction metrics
- Utilize advanced Excel functions (e.g., VLOOKUP) and reporting tools in CRM and SharePoint
- Manage complex billing scenarios including denials, rejections, and aging accounts
- Collaborate with Posting teams to resolve discrepancies and support month-end close
- Prepare and submit electronic claims, paper claims, and invoices (CMS-1500, UBs, invoices, and payer portals, etc.)
- Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections / resubmission, and follow-up with health plans
- Ensure accurate and compliant billing, following specific regulations of multi-state Medicaid and MCO's,Medicare Advantage, and Older Americans Act programs
- Responsible for ensuring aged outstanding balances of assigned payers is kept within department standards
- Participate in process improvement initiatives. Collaborate across teams to resolve issues, claims denials, and aging
- Other tasks as assigned, including but not limited to, assisting with projects that impact collections or write offs
Required Skills and Experience
High School Diploma or GED2+ years of work-related experience in healthcare related field, ie, healthcare billing institutional and professional claims, patient registration, and / or patient accessIntermediate level Excel skillsStrong oral and written communication skillsAbility to multi-task, set priorities, and pays close attention to detailStrong ability to work with team members across multiple departmentsAbility to work unsupervised with strong critical thinking and problem-solving skillsExperience with Waystar, CRM, D365, and / or electronic health record platformsMust have a wired internet connection using an ethernet port. Broadband internet wired to the home is required - Cable Modem / service or Fiber Optic. No Satellite, 4 / 5G, or DSL circuitsMust have a quiet workspace that is free from distractionPreferred Skills and Experience
Bachelor's degree in healthcare administration, medical administrative assistance, or healthcare financePrevious experience with electronic claims, such as electronic 835 / 837 claim and remit files, Zirmed, and / or secure payer web portalsAAHAM and / or HFMA certificationKnowledge of CMS regulation and strong familiarity with healthcare billing standards and complianceExperience with Waystar, CRM, D365, and / or electronic health record platformsPhysical Requirements
Repetitive motions that include the wrists, hands and / or fingersSedentary work that primarily involves sitting, remaining in a stationary position for prolonged periodsVisual perception to perform job including peripheral vision, depth perception, and the ability to adjust focusCompany Overview
Moms Meals is a home-delivered meal service providing fully prepared, refrigerated meal solutions direct to homes nationwide for over 25 years. We provide seniors, patients recovering post-discharge and those managing a chronic condition with tailored nutrition solutions to manage their specific needs. If you are passionate about the well-being of others and have a strong sense of community, Moms Meals could be the place for you! We are a family operated business looking for fun, compassionate, and friendly people who want to make a difference in the lives of others.
EEO
Moms Meals complies with all applicable federal and state non-discrimination laws. All qualified applicants shall receive consideration for employment without regards to race, religion, national origin, ancestry, color, gender, age, disability, sexual orientation or military status.