Billing Representative
Healthrise
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- Performs daily billing activities, including resolving billing edits and rejected claims to ensure accurate and timely claim submission
- Identifies routine billing issues and resolves or escalates them as appropriate
- Maintains working knowledge of state and federal laws related to insurance contracts and payer billing timelines
- Investigates and addresses overpayment and underpayment accounts to optimize reimbursement
- Applies payer rules, contracts, schedules, and related data to ensure claims are billed accurately and timely
- Researches payer trends and provides feedback to improve billing accuracy and operational efficiency
- Tracks and reports denial types and root causes, recommending process improvements
- Analyzes, categorizes, and resolves claim rejections from commercial, government, and managed care payers
- Documents all actions and follow-up activities in the patient accounting system
- Responds to patient and payer inquiries or refers them appropriately
- Prepares and submits reports documenting billing trends, outcomes, and claim activity
- Interprets data, draws conclusions, and reviews findings with supervisor
- Cross-trains in various functions to enhance service delivery
- Maintains knowledge of applicable federal, state, and local laws and regulations
Requirements
- High school diploma or Associate degree in Accounting, Business Administration, or a related field
- Minimum of two (2) to three (3) years of experience in revenue cycle medical billing, insurance follow-up, and denial management within one of the following settings: Hospital or clinic, Health insurance company or managed care organization, Healthcare financial services environment
- Excellent written and verbal communication skills
- Strong organizational and time-management skills with high attention to detail and accuracy
- Strong interpersonal and customer service skills
- Basic proficiency in Microsoft Office (Outlook, Word, PowerPoint, Excel)
- Familiarity with CPT, ICD-10, and HCPCS coding
- Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or equivalent certification preferred
Benefits
- Health insurance
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical billinginsurance follow-updenial managementCPT codingICD-10 codingHCPCS codingbilling accuracyreimbursement optimizationdata analysisclaim submission
Soft skills
written communicationverbal communicationorganizational skillstime-management skillsattention to detailinterpersonal skillscustomer service skills
Certifications
Certified Professional Biller (CPB)Certified Medical Reimbursement Specialist (CMRS)