Description:
Summary: The Billing Support Specialist is responsible for assisting the Revenue Cycle Manager with daily billing operations to ensure accurate and timely processing of claims. This role requires strong medical billing knowledge, a detail-oriented approach, and advanced Excel skills. The Billing Support Specialist will play a key role in resolving billing errors, managing denials, and supporting revenue optimization efforts.

Essential Duties (include but are not limited to):

• Support the Revenue Cycle Manager in daily billing operations.
• Add new clients to the billing platform and assign to appropriate processing rules.
• Review and resolve daily custom billing work queues.
• Review and resolve daily billing errors, such as missing diagnoses, missing insurance, and eligibility rejections.
• Communicate routinely with clients, account representatives, and field services to resolve billing errors and discuss billing trends.
• Review and resolve denied claims; identify and monitor denial trends by payer or client and recommend improvements to maximize revenue.
• Generate and review weekly sales reports for the leadership team.
• Process monthly vendor invoices into the billing system.
• Review and prepare daily mileage logs for submission to the billing system; resolve any errors.
• Periodically review test requisitions to ensure medical necessity.
• Manage medical records requests as requested by insurance companies or attorney groups.
• Process chain-of-custody requisitions for workers’ compensation claims.
• Respond to client or patient inquiries promptly and courteously.
• Assist with appeals, including identifying appeals and gathering appropriate documentation.
• Analyze monthly payments and billing metrics to identify areas for improvement.
• Participate in assigned project work.

Requirements:

EDUCATION & EXPERIENCE

• 3–5 years of medical billing experience, including strong knowledge of third-party payer rules and regulations.
• Prior laboratory billing experience strongly preferred.

KNOWLEDGE, SKILLS & ABILITIES

• Advanced Microsoft Excel proficiency is required; ability to use formulas, pivot tables, and data analysis functions.
• Proficient in Microsoft Office (Word, Outlook) and comfortable navigating payer websites.
• PowerBI knowledge preferred.
• Strong knowledge of insurance claims processes, including submission, denials, and appeals.
• Excellent communication and problem-solving skills.
• Strong organizational skills with the ability to manage multiple priorities.
• Positive, motivated attitude with a collaborative approach.

• Support the Revenue Cycle Manager in daily billing operations.
• Add new clients to the billing platform and assign to appropriate processing rules.
• Review and resolve daily custom billing work queues.
• Review and resolve daily billing errors, such as missing diagnoses, missing insurance, and eligibility rejections.
• Communicate routinely with clients, account representatives, and field services to resolve billing errors and discuss billing trends.
• Review and resolve denied claims; identify and monitor denial trends by payer or client and recommend improvements to maximize revenue.
• Generate and review weekly sales reports for the leadership team.
• Process monthly vendor invoices into the billing system.
• Review and prepare daily mileage logs for submission to the billing system; resolve any errors.
• Periodically review test requisitions to ensure medical necessity.
• Manage medical records requests as requested by insurance companies or attorney groups.
• Process chain-of-custody requisitions for workers’ compensation claims.
• Respond to client or patient inquiries promptly and courteously.
• Assist with appeals, including identifying appeals and gathering appropriate documentation.
• Analyze monthly payments and billing metrics to identify areas for improvement.
• Participate in assigned project work