Billing Specialist

Caron Treatment Centers; Wernersville (Berks County); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Caron Treatment Centers in Wernersville, PA is seeking a Billing Specialist to join our revenue cycle team. The role focuses on patient account activity, insurance claim processing, and ensuring accurate billing and timely payments.

Candidates should have a high school diploma, at least two years in electronic billing, and knowledge of health insurance policies. On-site requirement includes coming to campus one day per week with flexibility for remote work as needed.

Qualifications

• High school diploma or equivalent required.
• 2 years’ previous experience in an electronic billing environment required.
• Knowledge of health insurance medical billing policies and procedures required.
• Previous experience with electronic claims submission and remittance processes preferred.

Responsibilities

• Review patient account activity to understand amounts due.
• Contact third party payers for claim status and denials.
• Pursue adjudication of claims with payers to maximize payment.
• Prepare and mail patient statements and refund requests.
• Respond to inquiries about account status and payments.
• Coordinate payment plans and funding alternatives.
• Assist with accounts sent to external collection agencies.
• Maintain revenue cycle data integrity and assist with training.

Skills

Electronic billing

Communication skills

Customer service

Teamwork

Attention to detail

Education

High school diploma or equivalent

Tools

Electronic billing software

Claims submission portals

Remittance processing systems

Job description

Join a purpose-driven team at Caron Treatment Centers, where for nearly 70 years, we’ve been helping people find a path to recovery from addiction and rebuild their lives. We offer real careers with real opportunities for growth, comprehensive training, and a commitment to work-life balance. Our benefits include generous paid time off, professional growth and development, company-paid life and disability insurance, tuition reimbursement, a competitive 401(k) plan, and robust medical, dental, and vision plans . We’re proud to foster a diverse and inclusive environment, with a culture of teamwork, compassion, and dedication to our mission. S tart a career that saves lives at a company that values yours!

Monday-Friday 8am-4:30pm

Candidates must have the ability to come to the Wernersville, PA campus 1 day per week, additional days as needed

BILLING SPECIALIST DUTIES AND RESPONSIBILITIES:

• Review patient account activity to obtain understanding of remaining outstanding amounts due fromthepatient orinsurance fundingsources.
• Contact third party payers ona timelybasis to obtain claim processing status and clarificationregardingclaim payment denials.
• Assertively pursue proper adjudication of claim with third party payer while serving as an advocate to both the organization and patient to receive maximumappropriate payment
• Process necessary adjustments to the patient’s account to reflect net amounts due after scholarships and contracted discounts.
• Preparetimelyandaccuratepatient statementsand refund requestsaccording to department policies and procedures and ensure proper mailing ofsame.
• Respond toall phone calls from patients and private partiesregardingany inquiry related to patient account status, including prior insurance payments or denials.
• Be able toproperly communicatetopatientsallorganizational policiesregardingscholarship funding.
• Work withappropriate responsibleparties toarrange forpayment plans or other funding alternatives according to department policy.
• Prepare and coordinate all necessary documents and correspondence related to payment plans.
• Assistswith the submission and processing of all accounts sent toexternalcollection agency.
• Communicate with theSupervisor of Patient Billing and Accountingregardingany potential adjustments toaccountbalances.
• Alwaysmaintainprofessionalismwhen communicating and resolving outstanding balances with patients andthird-party funding sources.
• Work with internal departments to provide patients with any requested (andappropriate)information related to their treatment that mayassistthem with potential cost recovery.
• Support other department memberswith revenue cycle functionsduring staffingshortages and absences.
• AssistDepartment Leadershipin achieving goals andobjectivesestablishedby Senior Leadership for the department.
• Utilizethe electronic systems and softwareso that maximum efficiencies areobtainedandappropriately escalatissues related to such systems to the proper personnel.
• Abide by any provisions outlined in Third Party ReimbursementContracts when performing revenue cycle functions.
• Maintainthe integrity of all elements of the revenue cycle database whenperforming related revenue cycle functions.
• Assistwith the trainingand orientation of new employeesas directed by Department Leadership.
• This job description reflects management’s assignment of essential functions; it does not prescribe or restrict other tasks that may be assigned.

Education / Experience Qualifications:

• High school diploma or equivalent required
• 2 years’ previous experience in an electronic billing environment required
• Knowledge of health insurance medical billing policies and procedures required
• Previous experience in electronic claims submission and remittance processes preferred
• If in recovery, 1 year of continuous sobriety preferred

Physical Requirements:

The physical and mental demands described here are representative of those that must be met to successfully perform the essential functions of this job.Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Must be able tolift upto 25 pounds
• Will need to sit,standand type for extended periods of time
• Flexibility to work on campus andremotely as requested

Knowledge, Skills and Abilities:

• Proficiency with electronic billing management systems, including claims submission and electronic remittance advice processes.
• Can work successfully in a high-pressure environment and respond to multiple priorities.
• Ability to work as a member of a team and to proactively identify necessary changes to processes and procedures which lead to greater efficiencies.
• Capable of resolving problems independently, coupled with the ability to discern the need for escalation and intervention.
• Detail oriented with strong organizational skills.
• Strong technical knowledge and proficiency with computer software systems, specifically Microsoft products such as Power Point, Excel, and Word and data base management systems.
• Must possess excellent communication and customer service skills and have a pleasant phone manner.

Qualifications

Education

Required

High School or better.

Experience

Required

2 years:

2 years:

Experience in an electronic patient accounting environment required

2 years:

2 years:

Experience with collections or private pay account management required.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.