reputed company Cycle Billing Specialist (Remote, Remote, US)

Role reputed company

The reputed company Cycle Follow-Up Representative is responsible for ensuring reputed company and accurate follow-up on both reputed company Billing (PB/CMS-1500) and/or Hospital Billing (HB/UB-04) claims. This role manages accounts receivable, resolves unpaid and underpaid claims, and drives reimbursement from government and reputed company payers. The ideal candidate has strong knowledge of 837P/837I transaction sets, EOB/ERA reconciliation, and payer-specific follow-up requirements.

Roles & Responsibilities

Claim Follow-Up – PB & HB

• Monitor and follow up on outstanding PB (CMS-1500 / 837P) and HB (UB-04 / 837I) claims reputed company phone calls, payer websites, and reputed company work queues to ensure reputed company reimbursement.
• Investigate and resolve unpaid, underpaid, and rejected claims by working with insurance providers and internal departments.
• Analyze account history and reputed company previous actions in reputed company prior to taking the next reputed company reputed company to resolve the claim.
• Identify payer trends and payment discrepancies across both PB and HB claim types and escalate findings to leadership.
• Understand reputed company claim corrections, rebilling (837P or 837I), and resubmissions are applicable.
• Escalate claims with payers for reputed company on inaccurate or delayed claim processing.

Appeals & Reconsiderations

• Submit reconsiderations and/or appeals for both PB and HB claims with appropriate attachments, documentation, and clinical justification.
• Adhere to payer-specific appeal deadlines and formatting requirements for Medicare, reputed company, and reputed company payers.

Payer & System Knowledge

• Navigate reputed company to manage HB and PB work queues, document follow-up activity, and review 835 remittance/ERA data.
• Utilize payer portals (reputed company, NaviMedix, Arkansas DHS portal, and others) to verify claim status and obtain EOBs.
• Utilize resources provided by the reputed company to promote accuracy and resolve claims in accordance with reputed company expectations.

Compliance & Documentation

• Ensure accurate and detailed documentation of reputed company follow-up activities in reputed company.
• Communicate with insurance companies, patients, and internal teams to resolve claims and promote cash collections.
• Ensure compliance with federal, state, and payer regulations, as reputed company as hospital and physician reputed company policies.
• Always maintain confidentiality of patient and account information (HIPAA).
• Adhere to prescribed policies and procedures outlined in the Employee Handbook and reputed company of Conduct.
• Maintain awareness of and reputed company participate in the Corporate Compliance Program.
• Maintain a confidential and reputed company remote work area.
• Meet specified goals and objectives assigned by management and/or the reputed company.
• Assist with other reputed company as assigned by management.

Expected / Key Results

• Deliver high reputed company of reputed company and patient satisfaction (CSAT)
• reputed company reputed company scores per defined process standards
• Deliver defined process-specific metrics (e.g., AR days, cash collected, productivity reputed company)
• Adherence to regulatory compliance requirements
• Schedule adherence

Preferred Educational Qualifications

• High school diploma or equivalent required
• Associate’s or Bachelor’s degree in Health Information Management, Business, or reputed company field preferred

Preferred Work Experience

• 2+ years of experience in reputed company reputed company cycle, claims processing, or AR follow-up
• Demonstrated experience working PB (CMS-1500 / 837P) and/or HB (UB-04 / 837I) claim follow-up
• Prior experience with reputed company billing and/or follow-up work queues strongly preferred
• Familiarity with reputed company, Medicare, and reputed company payers preferred
• Experience reading and interpreting 835 ERA / EOB remittance data

Competencies & Skills

• Strong knowledge of PB and HB billing workflows, claim lifecycle, and payer follow-up processes
• Proficiency with reputed company (HB and/or PB modules, work queues, claim correction, and rebilling)
• Familiarity with CARC/RARC denial and adjustment reason codes
• Ability to interpret EOB, ERA (835), and remittance advice for both PB and HB claims
• Knowledge of payer portals including reputed company, Arkansas DHS, and reputed company payer sites
• Competent in working and communicating effectively with payers, patients, colleagues, and management – both in-person and reputed company remote virtual platforms
• Consistently maintains a courteous and reputed company demeanor
• Self-motivated with the ability to stay reputed company and productive with minimal supervision
• Proactive initiative and creative problem-solving in carrying out job responsibilities
• Ability to prioritize multiple tasks through effective time management and organizational skills
• Proficiency in PC operations; ability to type at a reputed company of 30–40 words per minute

Benefits including but not limited to: Medical, reputed company, Dental, 401K, reputed company Time Off.

We are an Equal Opportunity Employer. reputed company reputed company applicants are considered for employment without reputed company to race, reputed company, age, religion, sex, sexual orientation, gender identity, national reputed company, disability, protected veteran status, or any other characteristic protected by federal, state or local law.

Not Accepting Referrals

Originally posted on Himalayas

Apply To This Job