Billing Specialist

Ivy Fertility-Sage Fertility; St. Louis (MO); Teletrabalho; USD 55 000 - 75 000; Tempo integral

Resumo da oferta

Ivy Fertility-Sage Fertility is seeking a detail-oriented Billing Specialist to manage insurance claims and collections for a fertility practice in a fully remote role. You will research AR issues, prepare appeals, and work with carriers, patients, and internal teams to drive timely collections.

Responsibilities include processing claims, denials, and refunds, posting payments, and maintaining audit trails while ensuring HIPAA and FDCPA compliance. Strong Excel skills and CPC helpful.

Qualificações

• 2+ years of medical billing/accounts receivable experience.
• CPT, ICD-10, HCPCS coding knowledge required.
• Fertility billing experience preferred but not required.
• Strong knowledge of payer policies and HIPAA compliance.

Responsabilidades

• Review outstanding claims and make status calls to insurance companies.
• Research and resolve AR problems and denied claims with payers and patients.
• Submit corrected claims and reprocess as needed for payment.
• Post insurance and patient payments accurately for month-end close.
• Set up patient payment plans and monitor auto-pay enrollments.
• Answer patient inquiries with professional, compassionate tone.
• Escalate seriously delinquent accounts per policy and law.
• Assist with refunds, credits, adjustments, and audit trails.

Conhecimentos

Detail-oriented

Analytical thinking

Strong communication

Team collaboration

Problem solving

Typing speed 45 WPM

Formação académica

Associate degree in Medical Billing or Accounts Receivable

CPC certification preferred

Ferramentas

Excel

Descrição da oferta de emprego

Company OverviewSage Fertility is an elite fertility practice dedicated to exceptional clinical outcomes and an outstanding patient experience. Guided by our shared vision, mission, and values, we strive to expand access to fertility care, deliver best-in-class results, and support patients on their journey to building a family.Position SummaryWe are seeking a detail-oriented and knowledgeable Billing Specialist to manage insurance claims and collections, resolve accounts receivable issues, and support patient collections for our fertility practice. This role involves detailed research and follow-up on medical insurance claims, preparing appeals, and working closely with insurance carriers, patients, and internal teams to drive timely and accurate collections. The specialist will collaborate with staff and management to help meet organizational billing and collection goals on a daily, weekly, monthly, and yearly basis. This is a fully remote position.ResponsibilitiesReview outstanding claims to determine what action needs to take place, and make status calls to insurance companiesResearch and resolve accounts receivable problems and disputed or delinquent account balances with patients and insurance companies, including misapplied payments, direct deposits, and overpaymentsRequest claim reprocessing where necessary, or prepare and submit corrected claims to insurance companies for paymentResearch and resolve claim rejections and denials from electronic submissions, including accessing payer websites to identify the reason for rejection when neededReport on and work outstanding insurance and patient accounts receivable over 45 days, documenting collection effortsReview prior collection efforts each month to confirm payment was receivedInitiate appropriate collection action on delinquent accounts, including phone calls and correspondence to insurance carriers and patientsContact patients regarding balances after insurance processing, using a professional and compassionate tone, and send statements, reminders, and final notices on scheduleSet up and monitor patient payment plans and auto-pay enrollments in line with clinic policyPost patient payments (credit card, ACH, check, cash) accurately and in a timely mannerAnswer patient calls and inquiries relating to their bills, explaining how claims were processed by the carrier and supplying documentation (e.g., EOBs, patient ledgers) as requestedUpdate demographic and payer-related information obtained from patientsResearch insurance and patient refund requests, complete refund paperwork, and prepare refund requests for management approvalProcess credits, adjustments, and write-offs in accordance with approval guidelinesEscalate seriously delinquent patients accounts to management for review, including referral to third-party collections, in accordance with clinic policy and applicable lawDocument changes in insurance, billing systems, and clearinghouses to maintain an accurate audit trailPost insurance payments in a timely manner (within 2 business days) and ensure all payments are posted for month-end closeRegister online with insurance carriers to obtain claim and eligibility information via the webResponsible for the generation and mailing of claimsWork directly with team members, providers, and management on appeals and denials from insurance payorsInform management of insurance changes or trends that could affect claims submission and processingAssign and verify diagnosis and procedure codes using ICD, HCPCS, and CPT coding systems, ensuring accuracy and correct sequencing in accordance with government and insurance regulationsFollow up with providers on documentation that is insufficient or unclear, and communicate with clinical staff regarding documentationEnsure ongoing compliance with medical coding policies, HIPAA, PCI standards, and billing/collection regulations (e.g., FDCPA and state law)Support management on special projects and prepare reports as requestedPerform other duties as assignedQualificationsAssociate degree in Medical Billing, Accounts Receivable, or related field preferredMinimum of 2 years of direct medical billing/accounts receivable/coding experience, ideally in a medical office practice setting (fertility billing background preferred but not required)CPC certification preferredWorking knowledge of medical accounts receivable, insurance and patient collections, rejects, denials, appeals, and related billing guidelines and policiesDemonstrated knowledge of CPT, ICD-10, and HCPCS codingFamiliarity with medical insurance terminology and third-party payer reimbursement policies and procedures, including reimbursement reductions and fee schedule calculations/comparisonsStrong knowledge of anatomy, physiology, and medical terminologyStrong analytical and problem-solving skills, with the ability to identify root causes of issuesAbility to communicate effectively, accurately, and concisely, both verbally and in writingAbility to work independently and collaboratively as part of a teamHighly detail-oriented with strong prioritization and multi-tasking skills in a fast-paced environmentStrong customer service orientationSuperior mathematical skillsProficient in Excel and general computer systems/softwareStrong typing and 10-key speed and accuracy (minimum 45 WPM typing)Ability to establish and monitor performance/productivity standardsAttributesHighly process-oriented and detail-focusedExcellent interpersonal, communication, and customer service skills with staff and patientsEmpathy and discretion when discussing sensitive financial and family-building mattersFirm, professional, and confident handling of past-due balancesDependable, reliable team player who can also work independentlyGoal-oriented with a positive attitudeAble to troubleshoot and resolve ongoing problemsAble to handle stressful situations while maintaining professionalism and composureBuilds strong working relationships with patients, management, physicians, and internal teamsIvy Fertility is an equal opportunity employer. Employment decisions are based on merit, qualifications, performance, and business needs. Ivy Fertility does not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, sex, sexual orientation, gender identity or expression, veteran status, or any other status protected by applicable federal, state, or local law.