Remote Billing Specialist – Fertility Care

Remote Jobs; St. Louis (MO); Remote; USD 48,000 - 76,000; Full time

Job summary

Sage Fertility is seeking a Billing Specialist to manage insurance claims, AR, and patient collections for a fully remote fertility practice. You will research, appeal, and resolve denials, post payments, and monitor aging while ensuring HIPAA compliance and accurate coding (ICD/CPT/HCPCS).

The role emphasizes attention to detail, strong communication, and collaboration with insurance carriers, patients, and internal teams to meet billing goals.

Qualifications

• Associate degree in Medical Billing, Accounts Receivable, or related field preferred.
• Minimum of 2 years of direct medical billing/accounts receivable/coding experience, ideally in a medical office practice setting (fertility billing background preferred but not required).
• CPC certification preferred.
• Working knowledge of medical accounts receivable, insurance and patient collections, rejects, denials, appeals, and related billing guidelines and policies.
• Knowledge of CPT, ICD-10, and HCPCS coding.
• Familiarity with medical insurance terminology and third-party payer reimbursement policies and procedures, including reimbursement reductions and fee schedule calculations/comparisons.
• Strong knowledge of anatomy, physiology, and medical terminology.
• Strong analytical and problem-solving skills.
• Ability to communicate effectively, accurately, and concisely, both verbally and in writing.
• Ability to work independently and collaboratively as part of a team.
• Highly detail-oriented with strong prioritization and multi-tasking skills in a fast-paced environment.
• Strong customer service orientation.
• Superior mathematical skills.
• Proficient in Excel and general computer systems/software.
• Strong typing and 10-key speed and accuracy (minimum 45 WPM typing).
• Ability to establish and monitor performance/productivity standards.

Responsibilities

• Review outstanding claims to determine action and make status calls to insurance companies.
• Research and resolve accounts receivable problems and disputed balances with patients and insurers.
• Request claim reprocessing or submit corrected claims for payment.
• Research and resolve claim rejections and denials from electronic submissions.
• Report on and work AR over 45 days, documenting collection efforts.
• Review prior collection efforts each month to confirm payment.
• Initiate appropriate collection action on delinquent accounts.
• Contact patients regarding balances, send statements, reminders, and final notices on schedule.
• Set up and monitor patient payment plans and auto-pay enrollments.
• Post patient payments accurately and timely.
• Answer patient calls/inquiries, explaining claim processing and supplying documentation as requested.
• Update demographic and payer-related information from patients.
• Research insurance and patient refund requests, complete refunds, and prepare for management approval.
• Process credits, adjustments, and write-offs per guidelines.
• Escalate seriously delinquent accounts to management, including third-party collections when needed.
• Document changes in insurance, billing systems, and clearinghouses to maintain audit trails.
• Post insurance payments within 2 business days and ensure month-end close.
• Register online with insurance carriers to obtain claim and eligibility information.
• Responsible for generation and mailing of claims.
• Collaborate with team, providers, and management on appeals/denials from payors.
• Inform management of insurance changes or trends affecting claims processing.
• Assign and verify diagnosis and procedure codes (ICD, HCPCS, CPT) with proper sequencing.
• Follow up with providers on insufficient/unclear documentation and coordinate with clinical staff.
• Ensure compliance with medical coding policies, HIPAA, PCI standards, and billing/collection regulations.
• Support management on special projects and prepare reports as requested.
• Perform other duties as assigned.

Skills

Analytical skills

Detail-oriented

Customer service

Education

Associate degree in Medical Billing/AR

CPC certification

Tools

Microsoft Excel

Job description

Sage Fertility is seeking a Billing Specialist to manage insurance claims, AR, and patient collections for a fully remote fertility practice. You will research, appeal, and resolve denials, post payments, and monitor aging while ensuring HIPAA compliance and accurate coding (ICD/CPT/HCPCS).

The role emphasizes attention to detail, strong communication, and collaboration with insurance carriers, patients, and internal teams to meet billing goals.