Specialty Billing and Collections Analyst

Responsibilities

• Conducts monthly pre‑billing review and data quality analysis to ensure that invoices delivered to customers and providers are accurate.
• Regularly receives and processes client and provider adjustments to ensure month end invoices are correct.
• Uses a variety of collection techniques and forms relationships with business clients to resolve payment issues and escalates collection efforts as necessary.
• Submits specialty billing for PACE and Medicaid clients using EDI software portal, reconciles EOBs, denied claims and conducts accounts receivable follow‑up.
• Updates pricing on orders in system to ensure invoice accuracy for special items, agreements, substitutions, and unauthorized deliveries.
• Functions as a key contact person for all billing data integrity matters for clients, vendors, and various internal departments.
• Creates and develops reports to address management needs; analyzes information to identify issues and recommends process improvements as appropriate.
• May manage special billing & collections projects.
• Protects company’s intellectual property and the privacy of customers’ data.
• Performs other duties as assigned or apparent.

Qualifications

• High school diploma or equivalent is required.
• A bachelor’s degree in business or related field is preferred.
• Medical billing and coding license is preferred.
• At least two years of billing analytical experience in which employee worked within a team environment is required.
• Experience in the healthcare or medical fields in which incumbents have gained an understanding of durable medical equipment is preferred.
• Proficient and accurate data‑entry skills are required to record and manipulate data as previously described.
• Strong interpersonal skills due to constant contact both internally and externally; displays the ability to work within a team.
• Ability to work independently and displays good prioritization skills.
• A high attention to detailed information is required to review and reconcile data.
• Ability to read service level contracts and understand the fee schedule for client and vendors.
• The ability to maintain confidentiality of patient information and follow standard operating procedures with regard to patient data to ensure compliance with HIPPIA is required.
• Strong knowledge of business and communications software (MS Office) and web‑based tools is required.
• Excellent spreadsheet (Excel) experience is required.
• Experience with DMETrack software of at least one year is preferred.