Billing & Accounts Receivable Specialist

Billing & Accounts Receivable Specialist

Full Time THINK Neurology for Kids - Park Row, Houston, TX, US

Job Description

Reports to: Business Office Manager

Position Summary: The Billing & Accounts Receivable Specialist is responsible for supporting the full revenue cycle for a pediatric neurology practice utilizing eClinical

Works (ECW) and Waystar. This position focuses on timely claim submission, accounts receivable follow-up, denial management, payment posting, daily reconciliation, patient billing, and insurance collections.

The ideal candidate possesses a strong knowledge of medical billing regulations, payer requirements, and revenue cycle management processes. This individual must be detail-oriented, skilled in problem-solving, and capable of working independently while collaborating with providers, front office staff, credentialing personnel, and management to maximize reimbursement and maintain clean claims.

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 working with electronic health records and practice management systems; eClinical
  
  Works 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:

Revenue Cycle Knowledge

• Thorough understanding of claim submission, payment posting, denial management, and accounts receivable workflows.
• Knowledge of timely filing requirements and payer-specific billing guidelines.

Analytical and Problem-Solving Skills

• Ability to investigate unpaid, underpaid, denied, and rejected claims.
• Ability to identify root causes of reimbursement issues and recommend solutions.

Attention to Detail

• Maintains accuracy when entering charges, posting payments, reviewing EOBs/ERAs, and documenting account activity.

Organization and Time Management

• Effectively prioritizes daily claims processing, aging account work queues, reconciliation activities, and follow-up tasks according to the Business Office Manager's guidelines.

Communication Skills

• Professionally communicates with patients, physicians, insurance payers, and internal staff.
• Documents all account activity thoroughly and accurately within ECW.
• Works collaboratively with providers, front office personnel, authorization teams, credentialing staff, and management to resolve billing issues.

Claims Processing and Submission

• Review and verify completed encounters for billing readiness.
• Submit electronic claims through eClinical
  
  Works and Waystar in a timely manner.
• Monitor claim status and correct claim edits, rejections, and clearinghouse errors.
• Ensure claims meet payer-specific requirements prior to submission.
• Assist with medical record and documentation attachment workflows when required by payers.

Accounts Receivable Follow-Up

• Manage assigned accounts receivable work queues and aging accounts.
• Follow up on unpaid claims through payer portals, phone calls, correspondence, and online resources.
• Prioritize aging balances, including claims exceeding 90, 120, and 180 days.
• Investigate claim delays, medical records requests, coordination of benefits issues, and eligibility concerns.
• Document all collection efforts and payer communications within ECW.

Denial and Appeals Management

• Review insurance denials and identify trends affecting reimbursement.
• Prepare and submit corrected claims, reconsiderations, and appeals with supporting documentation.
• Research payer policies, coding requirements, medical necessity guidelines, and billing regulations to support appeals.
• Collaborate with management and providers to address recurring denial patterns.

Payment Posting and Reconciliation

• Post insurance and patient payments accurately and timely.
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
• Process payment adjustments in accordance with payer contracts and practice policies.
• Participate in daily reconciliation of posted payments, deposits, and bank activity.
• Assist with the preparation and maintenance of daily reconciliation reports and supporting documentation.

Patient Billing and Customer Service

• Assist patients with billing questions and account balances.
• Discuss payment options and payment arrangements consistent with practice policies.
• Generate and monitor patient statements.
• Communicate professionally and compassionately with families regarding financial responsibilities.

Coordination of Benefits and Insurance Verification Support

• Perform patient outreach related to coordination of benefits, demographic updates, and insurance-related corrections.
• Document all outreach attempts in accordance with departmental procedures.
• Assist in resolving eligibility, subscriber information, and coverage…