Job Title: Billing & Collection Specialist
Position Summary
The Billing & Collection Specialist plays a critical role in managing financial transactions, ensuring billing accuracy, and maintaining regulatory compliance. This position is responsible for accurate and timely billing for assigned service lines, analyzing patient accounts, identifying and resolving overpayments, processing refunds, and managing credit balances in accordance with established policies and industry regulations.
This role contributes directly to the organization’s revenue cycle performance by supporting and achieving key accounts receivable (AR) metrics and goals.
Key Performance Objectives
- Net and Gross Days Outstanding in Accounts Receivable
- Percentage of Accounts Receivable Aged > 90 Days
- Cash Collection Goals
- Credit Balances as a Percentage of Outstanding Receivables
- Denial Resolution and Prevention
Primary Responsibilities
- Perform daily activities to ensure timely resolution and closure of aged accounts receivable
- Submit claims, correct claim errors, and resolve RTP (Return to Provider) issues
- Conduct account status reviews and follow-up with payers as needed
- Investigate and resolve credit balances in compliance with regulations
- Respond to and resolve claim denials, including root cause analysis
- Manage correspondence related to billing and collections
- Support external audit requests, particularly those related to credit balances
- Ensure compliance with all payer guidelines and regulatory requirements
Required Skills & Qualifications
- Strong understanding of medical terminology, insurance billing practices, and reimbursement processes
- Experience with electronic health record (EHR) systems and billing platforms (e.g., Meditech or similar)
- Excellent analytical skills with strong attention to detail
- Prior experience in healthcare billing, revenue cycle management, or accounts receivable preferred
Core Competencies
- Strong interpersonal skills with the ability to work effectively across all levels of the organization
- Team-oriented mindset with a collaborative approach
- Excellent written and verbal communication skills
- Strong knowledge of the healthcare industry
- Highly detail-oriented and organized
- Ability to analyze issues and problem-solve effectively
- Capable of managing multiple priorities and meeting deadlines
- Maintains a professional and cooperative attitude with colleagues, patients, and external partners
- Ability to represent the organization positively to patients, insurance companies, and the public
- Quick learner with the ability to adapt to new processes and systems
Education & Experience
- High School Diploma required
- Associate’s degree in Healthcare Administration, Finance, Accounting, or related field preferred
Skills Required
- High School Diploma
- Associate's degree in Healthcare Administration, Finance, Accounting, or related field
- Strong understanding of medical terminology, insurance billing practices, and reimbursement processes
- Experience with electronic health record (EHR) systems and billing platforms (e.g., Meditech or similar)
- Excellent analytical skills with strong attention to detail
- Prior experience in healthcare billing, revenue cycle management, or accounts receivable
- Excellent written and verbal communication skills
- Ability to manage multiple priorities and meet deadlines
What We Do
Oneida Health is a nonprofit healthcare provider dedicated to providing high-quality, progressive, and comprehensive health care services for the greater Oneida area and surrounding communities. Operated by Oneida Health Systems, Inc., the organization includes a 101-bed acute care hospital, emergency department, surgery center, and a 160-bed extended-care and short-term rehab facility, along with various specialty care offices and diagnostic services.
