Medical Billing Specialist

Job Summary:
We are seeking dedicated professionals for dual roles in Insurance Follow-Up and Patient Collections Specialist positions. This hybrid role integrates critical functions of the revenue cycle, including insurance follow-up, claim resolution, patient collections, and payment reconciliation. The ideal candidates will demonstrate expertise in billing processes, collections, and customer service while collaborating with team members to achieve organizational performance expectations. This position serves as a vital link between patients, healthcare providers, and insurance companies, ensuring accurate, timely, and ethical resolution of accounts.

Supervisory Responsibilities: None

Reports to: Billing Manager

FLSA Status: Non-Exempt

Essential Duties and Responsibilities:

• Perform   daily insurance follow-up, including claim filing, denials management, appeals, and recoupment requests.
• Proactively   resolve claims edits, rejections, and corrected claims submissions.
• Handle inbound patient collection calls with professionalism and empathy, responding to inquiries promptly.
• Collect patient balances, establish repayment plans, and process payments   accurately.
• Batch, send, and manage patient statements (electronic and paper) while addressing returned mail.
• Utilize worklist reports to schedule follow-ups for outstanding accounts.
• Prepare and send collection letters while maintaining compliance with organizational policies.
• Collaborate with internal teams, including coders and payment posters, to reconcile   accounts and ensure accuracy.
• Maintain documentation for accounts placed with collection agencies and handle bankruptcy notices.
• Provide financial counseling to patients, explaining outstanding charges and resolving issues with a high standard of customer service.
• Stay updated on insurance payer trends, medical billing practices, and reimbursement methodologies.
• Ensure compliance with revenue cycle policies and confidentiality standards.
• Maintain proficiency in EMR, Epic.

Required Knowledge/Skills/Abilities:

• Advanced understanding of ICD-9, ICD-10, CPT, HCPCS, and their reimbursement      methodologies.
• Knowledge of insurance plan types, Medicare Parts A & B, and payer-specific      procedures.
• Proficient in Microsoft Office, EMR systems, and related technologies.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication abilities.
• Ability to maintain professionalism, confidentiality, and composure in high-stress      situations.
• Exceptional customer service skills and the ability to counsel patients effectively.
• Strong teamwork skills and the ability to promote a positive work environment.

Education and Experience:

• High school diploma or GED required, associate’s degree or higher preferred.
• 2-3   years of experience in a physician billing revenue cycle or central      business office setting.
• Experience in patient collections and understanding payer types and explanation of      benefits (EOBs).
• Preferred certification: Certified Patient Account Representative (CPAR).

Physical Requirements:

• Prolonged periods of sitting or standing at a desk and working on a computer.
• Ability to lift and transport up to 15 pounds occasionally.

Equal Opportunity Employer: Atlanta Women’s Healthcare Specialists is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, military or veteran status, gender, color or national origin in its employment practices.

Atlanta Women’s Healthcare Specialists participates in E-Verify to verify the authorization to work within the United States.

We conduct pre-employment drug screening and background checks in accordance with federal and state laws and regulations.