Medical Billing Specialist

Avance Care; Durham (NC); Hybrid; USD 42,000 - 52,000; Full time

Benefits offered by this job

Comprehensive benefits

Hybrid work schedule

Job summary

Avance Care in Durham, NC is seeking a Billing Specialist to secure revenue by ensuring timely payment of claims and resolving initial rejections. You will bill, follow up, and adjudicate billing for all clinical services in a busy, fast-paced environment.

This full-time role offers a hybrid schedule (4 days remote, 1 day onsite) and comprehensive benefits, with on-time benefits starting after 30 days of employment.

Qualifications

• High School Diploma or post-secondary certificates in related field preferred.
• 1–2 years related billing experience preferred.
• Strong verbal and written communication skills are required.
• Knowledge of payer policies and insurance processing preferred.

Responsibilities

• Oversee end-to-end claim cycle until resolution.
• Resolve front-end rejections in clearinghouse and billing software.
• Research and resolve payer denials, discrepancies and payment variances.
• Contact payers via calls, portals, fax or email to resolve denials and re-bill or bill patients as needed.
• Address incoming inquiries about denials or processing from insurance companies.
• Submit appeals with supporting information and follow up on all appeals.
• Provide medical records to insurers to assist with resolution.
• Process refunds and reconcile patient accounts in the billing system.

Skills

Verbal & written communication

Insurance practices

Payer policy research

Denial analysis

HCFA 1500 knowledge

Education

High School Diploma

Job description

Overview

Exciting Career Opportunity with Avance Care!

Join ourrapidly expandingnetwork of 37 practice locations in the Triangle Area (Raleigh-Durham-Chapel Hill), the Charlotte Region, and Wilmington, NC.

Avance Careis dedicated to elevating the standard of healthcare. As one of North Carolina's largest networks of independentprimary carepractices, we offercomprehensive servicesto support the physical, mental, and emotional health of our patients.

As aBilling Specialist you’ll secure revenue by ensuring timely payment of claims by insurance companies, resolving both initial rejections as well as processing errors by Avance Care payer partners and clearinghouses. You’ll also ensure maximum reimbursement to the organization by timely follow-up on all claims and having the necessary functions to bill, collect, analyze, and adjudicate billing functions for all clinical services.

• This is a full-time role involving8 hours weekday shiftswith no weekends schedule.
• The position works a hybrid schedule with 4 days remote and 1 day onsite.
• We operate in abusy, fast-paced environment, and we seek a candidate who thrives under such conditions.
• We offer acomprehensive benefitspackage available on the first of the month following 30 days of employment.

Selected Responsibilities

• Oversee the Claim Cycle to resolution, ensuring efficiency and accuracy
• Reviews and resolves front end rejections in Clearinghouse and Billing Software
• Research, address, and resolves all payer claim denials, account discrepancies and payment variances
• Contacts appropriate party regarding claims denial via outbound calls, insurance portals, fax, or email to ensure final resolution. Re-file or bill to patient as appropriate
• Addresses and resolves incoming phone calls from insurance companies regarding claim denials or processing
• Research and collect information to submit appeals. Follow-up on all billing related appeals
• Provide Medical Records and supporting documents to various insurance company websites to assist with claim resolutions
• Process insurance refunds and reconciles patient accounts in billing system
• Process patient payments over the phone, post payments to appropriate accounts and provides receipts
• Collaborates with Payments/Collections Team and Outsource Call Center associates regarding patient inquiries
• Collaborates with Coding Team regarding discrepancies for claim denials
• Aids Practice locations regarding account, insurance, or billing process inquiries
• Completes audit for AR work performed by Outsource associates

Candidates should have a High School Diploma, or post-secondary certificates in related field, preferred. Along with 1-2 years related billing experience preferred.

Other Priorities

• Strong verbal and written communication
• Knowledge of insurance practices
• Payer policy research and analysis skills, preferred
• Denial analysis and trending skills, preferred
• Knowledge of the HCFA 1500 claim form, preferred

Avance Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, gender identification, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state or local law.