Summary
Saint Francis Ministries is hiring a Remote Billing Specialist to support Revenue Operations. The role manages healthcare billing, claims submission, payment posting, accounts receivable aging, denial resolution, payer follow-up, reporting, and billing workflows across multiple programs and payers.
Responsibilities
- Billing and management of claims for multiple programs and payers to achieve maximum reimbursement
- Maintain working knowledge of multi-state payer rules, including Medicaid/MCOs, commercial insurance, third-party liability, state contracts, grants, and inter-organizational billing requirements
- Ensure claims are submitted timely and in compliance with payer requirements, reviews remittance advice to identify underpayments or discrepancies
- Reduce rejections and denials by scrubbing claims for timely and accurate submission
- Manages the resolution of insurance claim denials through detailed review, correction, and resubmission to optimize revenue recovery
- Collaborates with internal teams to resolve billing issues and improve workflows
- Manages aging accounts by contacting commercial payers and state programs to ensure timely and accurate payment
- Monitors aging reports to prioritize follow-up efforts
- Identifies, verifies, and submits claims to secondary and tertiary insurance carriers to maximize reimbursement
- Accurately posts insurance and patient payments into Practice Management Systems (PMS)
- Prepares and maintains Excel worksheets, tracking tools, and ad hoc reports to support revenue cycle operations
- Prepares, or assists in the preparation of, financial reports, analyses, and special projects as needed
- Conducts follow-up with payers to resolve denials, rejections, and unpaid claims
- Maintain and manage Billing workflows across assigned programs to ensure efficient and consistent operations
- Reviews accounts to determine if adjustments are necessary
Skills
- High School diploma or equivalent
- Minimum of two years of billing experience in a healthcare setting
- Must be 21 years of age
- Must have a valid Driver's License
- Behavioral health preferred
Qualifications
Must Haves
- High School diploma or equivalent
- Minimum of two years of billing experience in a healthcare setting
- Must be 21 years of age
- Must have a valid Driver's License
Nice to Haves
- behavioral health preferred