Billing and Collection Specialist

Job Description

Job Description

Position Summary :

The Billing and Collections Specialist is responsible for managing complex billing and collections processes, including third-party insurance claims, patient account reviews, eligibility verification, and reprocessing of outstanding claims. This role also handles cash transactions and ensures timely posting of all receivables. The ideal candidate will have strong attention to detail, excellent communication skills, and the ability to meet deadlines while working collaboratively with internal teams and external payers to resolve billing discrepancies and ensure efficient revenue management.

Duties and Responsibilities :

• Prepare and submit claims to third-party payers, including Medicare, Medi-Cal, Denti-Cal, and commercial insurances.
• Review claims for accuracy, ensuring compliance with payer-specific requirements and regulations.
• Follow up on unpaid or denied claims, reprocessing them as necessary to secure payment.
• Generate and distribute billing statements to patients and third-party payers.
• Monitor accounts receivable, working diligently to reduce outstanding balances and increase collection rates.
• Process patient payments, ensuring all transactions are accurately recorded and posted on the same day.
• Balance daily batches and maintain accurate financial records.
• Prepare and review encounter reports, addressing any discrepancies in visit documentation and billing codes.
• Evaluate accounts for corrections, including adjustments, write-offs, and charge reversals, in line with established policies.
• Collaborate and communicate with clinic administrators, front-line staff, and vendors to resolve billing issues and discrepancies.
• Maintain open communication with the Billing Project Coordinator and Supervisor regarding claim status, workflow, and other critical billing matters.
• Uphold confidentiality and comply with HIPAA regulations in all billing activities.
• Identify areas for improving billing efficiency and accuracy, contributing to the overall financial health of the organization.
• Stay up-to-date with changes in billing regulations, payer requirements, and coding guidelines to ensure continued compliance.
• Perform additional duties as assigned.

Qualifications :

Preferred :

Employee Benefits :

At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes :

Become part of a team where your work matters. Apply today and help us change lives, one patient / client at a time.

JWCH Institute, Inc + Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.