firstPRO 360 is seeking an experienced Medical Billing & Collections Specialist to join a growing healthcare practice in Sandy Springs. This individual will be responsible for managing the full revenue cycle process, with a strong focus on insurance follow-up, collections, claims resolution, and account reconciliation. The ideal candidate will have a proven track record of improving collections, reducing outstanding balances, and ensuring timely reimbursement from insurance carriers and patients.
- Submit and monitor insurance claims for accuracy and timely reimbursement.
- Follow up with commercial insurance carriers, Medicare, Medicaid, and other payers regarding unpaid, denied, or underpaid claims.
- Research and resolve billing discrepancies, claim denials, and payment variances.
- Manage patient account balances and conduct collection activities while maintaining excellent customer service.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) documents.
- Process claim appeals and supporting documentation as needed.
- Maintain accurate patient billing records and account notes within the practice management system.
- Reconcile accounts and ensure proper posting of payments and adjustments.
- Work closely with providers, front office staff, and management to resolve billing issues.
- Meet established collection and reimbursement goals.
- Maintain compliance with HIPAA and all applicable healthcare regulations.
- 3–4 years of recent medical billing and collections experience required.
- Strong understanding of medical insurance billing, claims processing, and collections procedures.
- Experience working with commercial insurance carriers, Medicare, and Medicaid.
- Ability to identify and resolve denied or unpaid claims efficiently.
- Knowledge of CPT, ICD-10, and HCPCS coding principles preferred.
- Experience using EMR/EHR and medical billing software.
- Strong attention to detail and organizational skills.
- Excellent communication and follow-up skills.
- Proficiency in Microsoft Excel and Microsoft Office Suite.
