The Role
Manage billing and revenue cycle tasks for assigned agencies: prepare and submit electronic and paper claims, reconcile accounts, research/resubmit claims, resolve denials, perform audits, reduce backlogs, mentor junior staff, use Excel/CRM/SharePoint reporting, and collaborate cross-functionally to ensure compliant, timely collections.
Summary Generated by Built In
The Billing Specialist is responsible for performing specified financial tasks in support of the day-to-day operations of the Billing/Revenue Cycle Department. We’re looking for someone with a strong internal drive to solve problems, drive collections, is a team player, and ensure every claim is handled with care and urgency.
Following training, this will be a hybrid position offering the opportunity to work 3 days in the office and 2 days remotely each week.
Position Responsibilities may include, but not limited to
- Create billing reports of assigned agencies
- Submit accounts receivable claims and/or invoices for weekly/monthly billing of assigned agencies
- Reconciliation of assigned state or local agencies
- Research and resubmit of billings to assigned agencies
- Review quality assurance of all referrals or updated clients from assigned state or local agencies
- Make outbound & inbound calls, emails to assigned state or local agencies with the purpose of securing correct information regarding new referrals, updated clients, and billings
- Responsible for executing complex billing tasks, mentoring junior staff, and leading cross-functional initiatives
- Reduce payment agency backlog
- Perform in-depth audits of project data to identify and resolve billing discrepancies
- Demonstrate successful performance through accuracy, timeliness, and customer satisfaction metrics
- Utilize advanced Excel functions (e.g., VLOOKUP) and reporting tools in CRM and SharePoint
- Manage complex billing scenarios including denials, rejections, and aging accounts
- Collaborate with Posting teams to resolve discrepancies and support month-end close
- Prepare and submit electronic claims, paper claims, and invoices (CMS-1500, UBs, invoices, and payer portals, etc.)
- Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans
- Ensure accurate and compliant billing, following specific regulations of multi-state Medicaid and MCO's, Medicare Advantage, and Older Americans Act programs
- Responsible for ensuring aged outstanding balances of assigned payers is kept within department standards
- Participate in process improvement initiatives. Collaborate across teams to resolve issues, claims denials, and aging
- Other tasks as assigned, including but not limited to, assisting with projects that impact collections or write offs
Required Skills and Experience
- High School Diploma or GED
- 2+ years of work-related experience in healthcare related field, ie, healthcare billing institutional and professional claims, patient registration, and/or patient access
- Intermediate level Excel skills
- Strong oral and written communication skills
- Ability to multi-task, set priorities, and pays close attention to detail
- Strong ability to work with team members across multiple departments
- Ability to work unsupervised with strong critical thinking and problem-solving skills
- Experience with Waystar, CRM, D365, and/or electronic health record platforms
- Must have a wired internet connection using an ethernet port. Broadband internet wired to the home is required - Cable Modem/service or Fiber Optic. No Satellite, 4/5G, or DSL circuits
- Must have a quiet workspace that is free from distraction
Preferred Skills and Experience
- Bachelor's degree in healthcare administration, medical administrative assistance, or healthcare finance
- Previous experience with electronic claims, such as electronic 835/837 claim and remit files, Zirmed, and/or secure payer web portals
- AAHAM and/or HFMA certification
- Knowledge of CMS regulation and strong familiarity with healthcare billing standards and compliance
- Experience with Waystar, CRM, D365, and/or electronic health record platforms
Physical Requirements
- Repetitive motions that include the wrists, hands and/or fingers
- Sedentary work that primarily involves sitting, remaining in a stationary position for prolonged periods
- Visual perception to perform job including peripheral vision, depth perception, and the ability to adjust focus
Company Overview
Mom’s Meals is a home-delivered meal service providing fully prepared, refrigerated meal solutions direct to homes nationwide since 1999. We provide seniors, patients recovering post-discharge and those managing a chronic condition with tailored nutrition solutions to manage their specific needs. If you are passionate about the well-being of others and have a strong sense of community, Mom’s Meals could be the place for you! We are a family operated business looking for fun, compassionate, and friendly people who want to make a difference in the lives of others.
EEO
Mom’s Meals complies with all applicable federal and state non-discrimination laws. All qualified applicants shall receive consideration for employment without regards to race, religion, national origin, ancestry, color, gender, age, disability, sexual orientation or military status.
Skills Required
- High School Diploma or GED
- 2+ years of healthcare-related experience (billing, institutional and professional claims, patient registration, or patient access)
- Intermediate Excel skills (including VLOOKUP and advanced functions)
- Strong oral and written communication skills
- Ability to multi-task, set priorities, and pay close attention to detail
- Ability to work effectively with team members across multiple departments
- Ability to work unsupervised; strong critical thinking and problem-solving skills
- Experience with Waystar, CRM, D365, and/or electronic health record platforms
- Experience preparing and submitting electronic and paper claims and invoices (CMS-1500, UBs, payer portals)
- Must have a wired broadband internet connection using an ethernet port (no satellite, 4/5G, or DSL)
- Must have a quiet workspace free from distraction (for remote days)
- Perform repetitive, sedentary work requiring visual perception and fine motor skills
- Experience with electronic claims workflows, denials management, and payer follow-up
- Ability to create billing reports, reconcile accounts, and conduct in-depth billing audits
- Prior experience making and receiving calls/emails to agencies to secure billing/referral information
- Bachelor's degree in healthcare administration, medical administrative assistance, or healthcare finance
- Previous experience with electronic 835/837 claim and remit files, Zirmed, and secure payer web portals
- AAHAM and/or HFMA certification
- Knowledge of CMS regulation and strong familiarity with healthcare billing standards and compliance
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