As the Billing Specialist, you will play a critical role in supporting the revenue cycle at Ally Medical by collaborating with a third-party billing partner to ensure timely and accurate claim processing, account resolution, and payer compliance. You will handle tasks related to insurance follow-ups, medical records, and account reviews with precision and confidentiality. Your attention to detail and commitment to service recovery will directly support the mission of delivering patient-centered care with integrity and excellence.
Duties and Responsibilities
- Perform follow-up on coordination of benefits (COB) and insurance ineligibility issues.
- Update patient insurance details and payer IDs to ensure claims are processed correctly.
- Monitor and resolve outstanding claims assigned through the third-party billing partner.
- Manage workers’ compensation and attorney-representation cases, including documentation and timely follow-up.
- Submit corrections or updates to billing workflows to address claim errors or rejections.
- Address deficiencies in medical records required for claim processing.
- Process attorney requests for medical records and affidavits in compliance with privacy regulations.
- Coordinate timely fulfillment of legal documentation for injury or litigation-related cases.
- Conduct detailed audits of patient statements to ensure billing accuracy.
- Review high-balance accounts and escalate as appropriate for resolution.
- Apply approved financial assistance discounts and service recovery adjustments.
- Maintain documentation for all billing activities and follow-ups.
- Assist in tracking and reporting billing performance metrics.
- Respond to internal inquiries related to insurance or billing discrepancies.
- Answer inbound calls from patients and payers regarding billing inquiries, account balances, insurance questions, and payment options.
- Resolve caller requests on first contact when possible and route escalations appropriately.
- Provide a compassionate, professional, and patient-centered experience on every call.
Requirements & Qualifications
Required Skills and Experience
- Strong understanding of insurance billing practices, COB policies, and denial management.
- Experience with third-party billing coordination and workflow follow-up.
- Familiarity with legal case billing, including workers’ compensation and attorney involvement.
- High attention to detail and analytical thinking.
- Clear and professional communication skills.
- Proficiency in EMR systems, billing platforms, and Microsoft Office Suite.
- Ability to manage multiple priorities and deadlines in a dynamic work environment.
- Discretion and integrity when handling sensitive patient and financial data.
- High school diploma or GED required.
- Bachelor’s degree in healthcare administration, accounting, or a related field preferred.
- Minimum of 2 years of experience in medical billing, preferably in an emergency care or acute care environment.
- Working knowledge of payer guidelines, EOBs, and patient financial policies.
- Prior experience with high-balance account review, discounts, and financial assistance programs is a plus.
Location
Austin, Texas, US
Employment Type
Not specified
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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