BILLING AND COLLECTIONS SPECIALIST

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 preferre