Billing Specialist - Remote at Gateway… · Pittsburgh

Description

If you’re detail-oriented, passionate about accuracy, and thrive in a fast-paced environment, we want to hear from you!

Gateway Rehab Center (GRC) has an outstanding opportunity for a remote Billing Specialist who will be responsible for the billing of patient services, performing follow-up on outstanding accounts receivable, processing refunds, patient denials and write-offs. This position receives infrequent supervision and instruction from the Manager of Billing Services.

Responsibilities

• Processes, edits, audits and posts service entries into the EHR.
• Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
• Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
• Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
• Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
• Participates in the monthly closings and provides data and analysis for all payers.
• Communicates with the utilization review department regarding authorizations issues and inquires.
• Completes necessary processes for adjustments, write-offs, charity care and refunds.
• Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.  
• Maintains interdepartmental reports for patient accounts and collections.
• Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
• Assists in the FY audits.
• Communicates with the Medical Records department for applicable data required for patient appeals and denials.
• Works on special projects as needed.
• Attends mandatory Gateway training and in-services.

Knowledge, Skills, and Abilities

• Understanding of healthcare billing practices 
• Familiarity with commercial insurance providers, including prior authorizations and claim submissions.
• Knowledge of the full billing cycle, including charge entry, claims processing, payment posting, and collections.
• Knowledge of basic accounting principles.
• Understanding of patient privacy laws and healthcare compliance standards.

Requirements

• High School diploma or equivalent required.
• Minimum of one year billing experience.

Other Requirements

• Pass a PA Criminal Background Check
• Obtain PA Child Abuse and FBI Fingerprinting Clearances
• Pass Drug Screen
• 2-Step TB Test

Work Conditions

• Favorable working conditions.
• Minimal physical demands.
• Significant mental demands include routine decision making, continuous attention to detail and high mental and visual concentration.
• Accuracy is critical in this position as errors may result in serious loss of revenue and delay of payments.

GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.