Medical Accounts Receivable Billing Specialist

WACBD - Washington Center for Bleeding Disorders; Seattle (WA); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Washington Center for Bleeding Disorders is seeking a Medical Accounts Receivable Billing Specialist to manage insurance/patient AR, ensure accurate billing and timely reimbursement, and support organizational financial health.

The role requires strong analytical skills, attention to detail, and a commitment to excellent patient service for those with chronic medical needs. Hybrid/remote options may apply based on policy.

Qualifications

• 2+ years in medical billing and A/R with certification.
• 5+ years in medical billing and A/R without certification (in lieu of).
• In-depth knowledge of CPT, ICD-10, and HCPCS coding principles.
• Proficiency with clearinghouses and payer portals.
• Strong analytical, problem-solving, and written communication skills.
• Experience with Microsoft Office, EHR, and practice management systems.

Responsibilities

• Review and monitor AR aging to identify balances and prioritize follow-up.
• Manage denials and appeals to secure reimbursement.
• Verify claim status with payers and resolve payment issues.
• Post, reconcile, and verify insurance payments accurately.
• Communicate with patients about eligibility and out-of-pocket costs.
• Reconcile remittance advice and resolve under/overpayments.
• Collaborate with internal teams to resolve billing issues.
• Report trends in denials and payer performance with management.
• Maintain accurate records of all account activity and correspondence.
• Assist with process improvements and SOP updates in collaboration with Revenue Integrity/Coding.

Skills

Insurance claims follow-up

Denial management and appeals

Accounts receivable analysis

Post payment and reconciliation

Customer service and patient comms

Attention to detail

Time management

Education

Associate degree or higher in business/finance/healthcare

Tools

Nextgen

R2

Newleaf/Keycentrix

Pharmacy Billing Software

Job description

The Position

The Medical Accounts Receivable Billing Specialist, reporting directly to the Revenue Cycle Manager, is responsible for managing and resolving insurance and patient accounts receivable, and ensuring accurate and timely billing, reimbursement, and collections. This role supports WACBD's financial health by monitoring outstanding balances, communicating with patients and payers, and maintaining meticulous documentation in accordance with organizational policies and healthcare regulations.

This position requires strong analytical skills, attention to detail, and a commitment to delivering exceptional service to patients with chronic and complex medical needs.

Key Responsibilities

• Review and monitor accounts receivable aging reports to identify outstanding balances and prioritize follow-up activities.
• Work complex denials (coding, medical necessity, eligibility, prior auth, duplicate, bundling, coordination of benefits) and submit appeals to secure reimbursement.
• Contact insurance companies to verify claim status, resolve payment issues, and request claim reprocessing when necessary.
• Post, reconcile, and verify insurance payments accurately.
• Communicate with patients regarding insurance eligibility, out-of-pocket costs, and benefits.
• Reconcile remittance advice (ERA/EOB), post payments and adjustments, resolve under/overpayments, and elevate variances.
• Collaborate with internal departments to resolve billing and reimbursement issues.
• Partner with management to discuss and report on trends in denials, performance, and insurance payers.
• Maintain detailed and accurate records of all account activity, follow-up efforts, and correspondence in the billing system.
• Collaborate with Revenue Integrity/Coding to correct charge capture and coding issues; contribute to process improvements and SOP updates.

Requirements

A minimum of (2) years of hands-on experience in medical billing and A/R, specifically managing claim follow-up, denials, appeals, and payment posting with certification or,

A minimum of (5) years of hands-on experience in medical billing and A/R, specifically managing claim follow-up, denials, appeals, and payments in lieu of certification.

In-depth knowledge of medical terminology, CPT, ICD-10, and HCPS coding principles

Proficiency with clearinghouses, payer portals

Demonstrated success improving A/R metrics (e.g., reducing DSO, increasing first-pass yield).

Strong understanding of payer policies, guidelines, and regulations for commercials, government (CMS), and third-party payers.

Strong analytical, problem-solving, and written communication skills; able to craft effective appeals with supporting documentation.

Prior experience in Microsoft Office, EHR, and practice management systems required

Skills

• Insurance claims follow-up
• Denial management and appeals
• Accounts receivable analysis
• Post payment and reconciliation
• Customer service and patient communication
• Attention to detail
• Time management

Professional Qualifications

• High degree of integrity, professionalism, and ethical conduct.
• Unwavering commitment to maintain strict patient confidentiality and adhere to all HIPAA regulations.
• Excellent written and verbal communication skills, with the ability to articulate complex information clearly and concisely.
• Cultivate diversity and respect.

Preferred Qualifications

• 340b Pharmacy billing
• Specialized Expertise- Active CPC, CPC-A, CPB, or CRCR.
• Associate degree or higher in business, finance, or healthcare-related studies
• Prior EHR experience in Nextgen, R2, Newleaf/Keycentrix, and related Pharmacy Billing Software.

Work Environment

• Full-time, Monday-Friday. Hybrid/remote options based on department policy.
• Ability to sit or stand at the workspace to work on the computer and telephone.
• Occasional overtime during month-end close or audits.