Responsible for supporting the full revenue cycle for a pediatric neurology practice using eClinicalWorks (ECW) and Waystar. This role focuses on timely claim submission, accounts receivable follow-up, denial management, payment posting, daily reconciliation, patient billing, and insurance collections.
The position requires strong knowledge of medical billing regulations, payer requirements, and revenue cycle processes. The specialist will work independently while collaborating with providers, front office staff, credentialing personnel, and management to maximize reimbursement and maintain clean claims.
Key responsibilities include claims processing and submission, accounts receivable follow-up, denial and appeals management, payment posting and reconciliation, patient billing support, coordination of benefits assistance, revenue cycle improvement, and compliance with HIPAA and billing regulations.
Required Education and Experience
- High school diploma or equivalent required
- Medical billing and coding coursework preferred
- Minimum one year of medical billing, accounts receivable, or revenue cycle experience preferred
- Experience with electronic health records and practice management systems; eClinicalWorks experience strongly preferred
- Experience with clearinghouse systems and electronic claims submission; Waystar experience preferred
- Working knowledge of ICD-10-CM, CPT, and HCPCS coding
- Understanding of commercial insurance, Medicaid, and managed care plans
- Pediatric specialty billing experience preferred
Essential Skills and Competencies
- Strong understanding of claim submission, payment posting, denial management, and accounts receivable workflows
- Ability to investigate unpaid, underpaid, denied, and rejected claims
- Strong attention to detail when entering charges, posting payments, reviewing EOBs/ERAs, and documenting account activity
- Excellent organization and time management skills
- Professional communication with patients, physicians, insurance payers, and internal staff
- Ability to collaborate with providers, front office personnel, authorization teams, credentialing staff, and management
- Familiarity with HIPAA, payer guidelines, and billing compliance requirements
Location
Houston, Texas, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago