The Billing & Denials Specialist supports middle-to-end revenue cycle operations, including claims billing, claims review, denial management, reconciliations, appeals, issue resolution, adjustments, and write-offs. The role focuses on maintaining healthy cash flow, regulatory compliance, and operational excellence for the FMS revenue cycle division.
This position works with Minnesota Medical Assistance (MA), PMAP/MSHO payers, and related programs such as the State of Minnesota Budget Model, CFSS, and Elderly Waiver programs.
Requirements & Qualifications
Qualifications
- Associate's degree and at least 2 years of relevant experience, or an equivalent combination of education and experience
- Experience in home care, SNF, or behavioral health billing preferred
- Experience using MNITS, Availity, and clearinghouses
- Revenue cycle or practice management software knowledge required
- Proficiency with Microsoft Word, Excel, Outlook, and Teams
- Strong knowledge of third-party payers and applicable healthcare laws, regulations, and guidelines
- Understanding of CPT and ICD-10 coding principles as they relate to claims processing
- Understanding of authorizations, service units, and modifier usage
- Excellent interpersonal, communication, organizational, and follow-up skills
- Strong analytical and problem-solving abilities
- Ability to work in a fast-paced virtual business environment
- Ability to meet metrics and KPI expectations
- Previous remote work experience preferred
- Ability to work independently with little supervision
Benefits & Perks
Benefits and perks
- Comprehensive medical, dental, and vision coverage for full-time employees
- 401(k) retirement plan
- HSA and FSA options
- Generous PTO
- Additional paid self-care day
- Paid community volunteering day
- Free mental health and wellbeing programs
- Training and professional growth opportunities
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 weeks ago