Reimbursement Specialist

Collin County Mental Health Retardation Center; McKinney (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

Collin County Mental Health Retardation Center is seeking a skilled Medical Billing Specialist to manage moderate complexity billing and AR follow-up. You will batch and submit claims, post payments, and track reimbursements while entering EOBs in the EHR system.

Rework denials, conduct reconsiderations and appeals, and reconcile issues with insurers. You will work with dual coverage plans, ensure HIPAA compliance, and use EHR reports to monitor KPIs.

Qualifications

• Knowledge of billing and coding requirements and insurance industry standards.
• Experience with denials management and appeals processes.
• Proficient with MS Word and Excel; familiar with EHR systems.

Responsibilities

• Performs moderately complex medical billing and accounts receivable follow-up.
• Batch/submits claims to multiple insurance companies; posts payments and tracks reimbursement.
• Enter EOBs, payments, and denials in the EHR system; manage rejections and reconsiderations.
• Submit medical records and reconcile issues with insurance companies; understand dual coverage plans.
• Utilize EHR reports to monitor claims and AR to align with KPIs; communicate with peers and management.

Skills

Billing & coding knowledge

Denials management

Communication skills

Organizational skills

Self-starter

Education

High School diploma or GED

CPB or CPC certification

Tools

MS Word

Excel

Claims clearinghouse experience

Job description

Performs moderately complex medical billing and account receivable follow up functions. Primary responsibilities include batch/submit claims to multiple insurance companies, post payments and track reimbursement. Enter EOB correspondence, payments, and denials in EHR system. Re-work rejections, conduct reconsiderations and appeals, submit medical records, and reconcile issues with insurance companies. Understand dual coverage plans to ensure accurate billing. Knowledgeable of medical claims standards, clearinghouse requirements and HIPPA. Utilize various reports in EHR to monitor claims and accounts receivable to align with KPI’s. Communicates with peers, consumers and management regarding insurance or claims issues. Assist and/or serve as backup in any billing area and other duties as requested by supervisor. Works under moderate supervision with considerable latitude for the use of initiative and independent judgment.Education, Training and Experience (including licensure and certification)Minimum High School diploma or General Education Degree (GED);Two (2) years related experience and/or training, or equivalent combination of education and experience.Knowledge of billing and coding requirements, insurance industry standardsKnowledge of insurance benefits, primary and secondary billing requirements, etc.Must be proficient with claims clearinghouse experience.Preferences: Minimum 3 years’ billing experience. CPB or CPC certificationKnowledge, Skills, and AbilitiesTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily.Proficient in billing guidelines, claims processing standards, and denials management.Must have good communication skills, well organized, a self-starter and ability to complete assigned duties in a timely manner.Knowledge of MS Word, Excel, medical practice management systems and computer operational skills.Must have a valid Texas driver’s license.