Specialty Billing & Collections Analyst

Essential Functions

1. Conducts monthly pre-billing review and data quality analysis to ensure that invoices delivered to customers and providers are accurate.
2. Regularly receives and processes client and provider adjustments to ensure month end invoices are correct.
3. Uses a variety of collection techniques and forms relationships with business clients to resolve payment issues and escalates collection efforts as necessary.
4. Submits specialty billing for PACE and Medicaid clients using EDI software portal, reconciles EOBs, denied claims and conducts accounts receivable follow‑up.
5. Updates pricing on orders in system to ensure invoice accuracy for special items, agreements, substitutions, and unauthorized deliveries.
6. Functions as a key contact person for all billing data integrity matters for clients, vendors, and various internal departments.

Marginal or Additional Functions

1. Creates and develops reports to address management needs; analyzes information to identify issues and recommends process improvements as appropriate.
2. May manage special billing & collections projects.
3. Protects company’s intellectual property and the privacy of customers’ data.
4. Performs other duties as assigned or apparent.

Supervisory and Managerial Responsibility

This position does not have supervisory or managerial responsibilities.

Knowledge, Skills & Abilities

Education, Licensure or Certification:

• High school diploma or equivalent is required.
• A bachelor’s degree in business or related field is preferred.
• Medical billing and coding license is preferred.

Work Experience or Related Experience:

• At least two years of billing analytical experience in which employee worked within a team environment is required.
• Experience in the healthcare or medical fields in which incumbents have gained an understanding of durable medical equipment is preferred.

Specialized Knowledge, Skills & Abilities:

• Proficient and accurate data‑entry skills are required.
• Strong interpersonal skills due to constant contact both internally and externally; displays the ability to work within a team.
• Ability to work independently and displays good prioritization skills.
• A high attention to detail is required to review and reconcile data.
• Ability to read service level contracts and understand the fee schedule for client and vendors.
• Ability to maintain confidentiality of patient information and follow standard operating procedures with regard to patient data to ensure compliance with HIPAA is required.

Equipment:

• Strong knowledge of business and communications software (MS Office) and web‑based tools are required.
• Excellent spreadsheet (Excel) experience is required.
• Experience with DMETrack software of at least one year is preferred.

Travel Requirements and Conditions

There are no travel requirements for this position.

Work Environment, Conditions and Demands

Work is generally performed in an office environment or remote setting in which there is only minimal exposure to unpleasant and/or hazardous working conditions.

Physical Requirements and Demands

Regular eye‑hand coordination and manual dexterity is required to operate office equipment.

Additional Position Information

No additional information is applicable.

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