Billing Specialist 1 at Gateway Rehabilitation Center – Moon, Pennsylvania

If you’re detail-oriented, passionate about accuracy, and thrive in a fast-paced environment, we want to hear from you!

Gateway Rehab Center (GRC) has an outstanding opportunity for a remote Billing Specialist 1 who will be responsible for the billing of patient services, performing follow-up on outstanding accounts receivable, processing refunds, patient denials and write-offs.

This position receives infrequent supervision and instruction from the Manager of Billing Services.

Responsibilities

• Processes, edits, audits and posts service entries into the EHR.
• Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
• Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
• Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
• Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
• Participates in the monthly closings and provides data and analysis for all payers.
• Communicates with the utilization review department regarding authorizations issues and inquires.
• Completes necessary processes for adjustments, write-offs, charity care and refunds.
• Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.
• Maintains interdepartmental reports for patient accounts and collections.
• Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
• Assists in the FY audits.
• Communicates with the Medical Records department for applicable data required for patient appeals and denials.
• Works on special projects as needed.
• Attends mandatory Gateway training and in-services.

Knowledge, Skills, and Abilities

• Understanding of healthcare billing practices
• Familiarity with commercial insurance providers, including prior authorizations and claim submissions.
• Knowledge of the full billing cycle, including charge entry, claims processing, payment posting, and collections.
• Knowledge of basic accounting principles.
• Understanding of patient privacy laws and healthcare compliance standards.

• High School diploma or equivalent required.
• Minimum of one year billing experience.

Other Requirements

• Pass a PA Criminal Background Check
• Obtain PA Child Abuse and FBI Fingerprinting Clearances
• Pass Drug Screen
• TB Test

Work Conditions

• Favorable working conditions.
• Minimal physical demands.
• Significant mental demands include routine decision making, continuous attention to detail and high mental and visual concentration.
• Accuracy is critical in this position as errors may result in serious loss of revenue and delay of payments.

GRC IS AN EQUAL OPPORTUNITY EMPLOYER M/F/D/V