Government Payer Billing Specialist

Northeast Georgia Health System; Gainesville (GA); On-site; USD 35,000 - 52,000; Full time

Job summary

Northeast Georgia Health System is seeking a Revenue Cycle Billing Specialist to manage third-party claims with governmental payers and perform delinquent insurance balance collection. You will review accounts, document activities clearly, and coordinate with payers and employers as needed.

The role requires at least 1 year of collection or business office experience and a high school diploma or GED. Strong attention to detail and teamwork are essential for success in this position.

Qualifications

• Licensure or other certifications:
• Educational Requirements: High School Diploma or GED.
• Minimum Experience: One (1) year minimum collection or business office experience.
• Other:

Responsibilities

• Review documentation in the NGMC Patient Accounting core system.
• Proficient in claims processing software; review and correct claims before submission.
• Maintain claims counts and dollars in the billing scrubber; alert supervisor if unresolved in 24 hours.
• Identify and mail hard copy claims for non-electronic payers (e.g., workers comp).
• Resolve claim rejections daily and report root causes to departments.
• Contact insurers via phone/web to expedite processing and payment.
• Complete Medical Records requests via HealthPort e-request system.
• Document patient accounts thoroughly for future collection needs, including court review.
• Assist other Revenue Cycle departments with insurance collection matters.
• Document collection efforts in Receivables Workstation to identify denial root causes.
• Contact patients for required documents/information for processing.
• Participate in Governmental Payer team and LEAN problem solving.
• Submit secondary claims electronically or hard copy with necessary primary payer info.
• Research core HIS system to root cause charge variances and plan resolution.
• Work on special projects like charge reconciliation and bad debt processing.
• Run time-sensitive AR reports on demand.

Skills

Govt billing regs

DDE / MMIS

UB04 data

Teamwork

Multi-tasking

Problem solving

Communication

Education

High School Diploma or GED

Tools

Core billing system

Receivables Workstation

Job description

Northeast Georgia Health System is seeking a Revenue Cycle Billing Specialist to manage third-party claims with governmental payers and perform delinquent insurance balance collection. You will review accounts, document activities clearly, and coordinate with payers and employers as needed.

The role requires at least 1 year of collection or business office experience and a high school diploma or GED. Strong attention to detail and teamwork are essential for success in this position.