Medical Revenue Cycle Biller

NuWest Group; Seattle (WA); On-site; USD 65,000 - 80,000; Full time

Job summary

NuWest Group is seeking a Medical Accounts Receivable Billing Specialist / Revenue Cycle Biller to join onsite in Seattle, WA. The role focuses on managing insurance and patient AR, ensuring accurate billing, reimbursement, and collections while maintaining compliance with healthcare regulations.

Responsibilities include reviewing aging, handling denials, submitting appeals, posting payments, reconciling accounts, and communicating with payers and patients.

Qualifications

• Experience in healthcare revenue cycle with a focus on AR and denial management.
• Familiarity with pharmacy billing processes is a plus.
• Ability to analyze, document, and communicate payer issues clearly.

Responsibilities

• Review AR aging reports to prioritize follow-ups.
• Manage complex denials including coding and eligibility issues.
• Prepare and submit appeals for reimbursement.
• Verify claim status with payers and request reprocessing when needed.
• Post and reconcile payments; review ERA/EOB statements.
• Post adjustments and resolve under/overpayments.
• Communicate with patients on eligibility and balances.
• Collaborate with internal teams to fix billing/reimbursement issues.

Skills

Insurance claims follow-up

Denial management

Accounts receivable analysis

Payment posting

Reconciliation

Payer communication

Medical billing

Attention to detail

Time management

Analytical problem-solving

Written and verbal communication

HIPAA compliance

Education

Associate degree or higher in business/finance/healthcare administration

CPC/CPC-A/CPB/CRCR certification

Tools

NextGen

R2

NewLeaf/Keycentrix

Job description

Medical Accounts Receivable Billing Specialist / Revenue Cycle Biller

***THIS IS AN ONSITE POSITION IN SEATTLE, WA. RELOCATION NOT PROVIDED.***

The Medical Accounts Receivable Billing Specialist reports directly to the Revenue Cycle Manager and is responsible for managing and resolving insurance and patient accounts receivable while ensuring accurate and timely billing, reimbursement, and collections.

This position plays an important role in supporting the organization's financial health by monitoring outstanding balances, communicating with patients and insurance payers, resolving complex claims and denials, and maintaining accurate documentation in accordance with organizational policies and healthcare regulations.

The ideal candidate has strong analytical and problem-solving skills, exceptional attention to detail, and a commitment to providing excellent 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
• Manage complex claim denials, including coding, medical necessity, eligibility, prior authorization, duplicate claims, bundling, and coordination of benefits issues
• Prepare and submit timely, well-supported appeals to secure appropriate reimbursement
• Contact insurance companies to verify claim status, resolve payment issues, and request claim reprocessing when necessary
• Post, reconcile, and verify insurance payments accurately
• Review and reconcile electronic remittance advice (ERA) and explanation of benefits (EOB) statements
• Post payments and adjustments and resolve underpayments and overpayments
• Escalate payment variances and complex reimbursement issues as appropriate
• Communicate professionally with patients regarding insurance eligibility, benefits, balances, and out-of-pocket costs
• Collaborate with internal departments to resolve billing, coding, charge capture, and reimbursement issues
• Partner with Revenue Integrity and Coding teams to correct charge capture and coding issues
• Maintain detailed and accurate documentation of account activity, follow-up efforts, appeals, and payer correspondence in the billing system
• Monitor payer trends and denial patterns and communicate findings to management
• Partner with management to report on accounts receivable performance, denial trends, and payer issues
• Contribute to process improvements, workflow enhancements, and standard operating procedure (SOP) updates
• Maintain compliance with organizational policies, payer requirements, and applicable healthcare regulations

Core Skills

• Insurance claims follow-up
• Denial management and appeals
• Accounts receivable analysis
• Payment posting and reconciliation
• Insurance payment variance resolution
• Patient and customer service
• Medical billing and reimbursement
• Strong attention to detail
• Time management and organization
• Analytical and problem-solving skills
• Written and verbal communication

Professional Qualifications

• High degree of integrity, professionalism, and ethical conduct
• Strong commitment to patient confidentiality and compliance with HIPAA regulations
• Excellent written and verbal communication skills, with the ability to explain complex information clearly and concisely
• Ability to work collaboratively with patients, payers, internal departments, and leadership
• Demonstrated respect for diversity and the ability to work effectively with individuals from diverse backgrounds
• Strong commitment to accuracy, accountability, and exceptional service

Preferred Qualifications

• Experience with 340B pharmacy billing
• Active CPC, CPC-A, CPB, or CRCR certification
• Associate degree or higher in business, finance, healthcare administration, or a related field
• Experience with NextGen, R2, NewLeaf/Keycentrix, or related pharmacy billing software
• Prior experience working with pharmacy billing systems and processes
• Experience in healthcare revenue cycle management