Overview: Provides administrative and operational support to the Billing Manager in managing revenue cycle functions, including claims follow-up, billing queue oversight, KPI monitoring, payment reconciliation, denial management, and recurring billing reports. ***Applicant must have CPC and live in RI/CT/MA as this position is onsite in RI***
Job Responsibilities:
· Assist with the accurate management of claim posting and ensure insurance and referral information is properly appended to claims prior to submission.
· Support accurate claims management on both the front and back end of claim submission.
· Review and resolve claim-related matters that are hindering payer payment.
· Assist in reconciliation of payer payments to posted ERAs and other payment records.
· Post patient payments and manage unapplied credits on patient ledgers.
· Reconcile providers’ surgical calendars to posted claims as needed.
· Work and resolve missing encounters.
· Assist in posting hospital service charges and entering patient demographics that correspond to such charges.
· Assist with outreach for outstanding patient collections balances and account resolution.
· Provide coding expertise and guidance to providers as needed.
· Review patient records regularly for compliance with proper coding guidelines and policies, under the supervision of the Billing Manager and Practice Administrator.
· Support daily review of billing work queues, assigned claims buckets, and open follow-up items to ensure timely completion.
· Monitor billing performance trends and key indicators including denial rates, A/R aging, practice bucket upkeep, missing encounters, and collections activity.
· Assist with preparation and maintenance of recurring billing reports, including unapplied payments, outstanding charges, patient credits, adjustments, held statements, returned statements, and month-end reports.
· Assist with bank payment reconciliation, patient portal payments, refund processing, and other recurring billing reconciliation activities.
· Support payment plans for patients, payer audit record requests, and other billing-related follow-up tasks as assigned.
· Track workflow gaps, recurring issues, or delays and escalate concerns to the Billing Manager or Practice Administrator as needed.
· Perform other duties as assigned by the Billing Manager, Practice Administrator, and/or leadership team.
Qualifications:
· Three (3) to five (5) years of experience working in medical billing
· Completion of a coding certification program and Coding Certificate through AAPC, AMA or other accredited program.
· Experience with billing KPI reporting and revenue cycle metrics
· Familiarity with denial management and A/R aging review
· Ability to prioritize high-volume billing tasks across multiple worklists
· Experience with monthly reporting and payment reconciliation
· Must have a strong knowledge of medical terminology
· Highly Proficient in Microsoft Office Suite
· Polished Communication skills both written and verbal
Core Performance Expectations
· Maintain timely follow-through on daily, weekly, and monthly billing tasks
· Support accurate and compliant claim processing and coding review
· Identify and escalate unresolved billing or claims issues promptly
· Assist in maintaining strong performance across revenue cycle metrics
· Contribute to billing workflow efficiency, accuracy, and financial accountability
This role is ideal for motivated professionals eager to leverage their coding expertise in a collaborative healthcare environment. We are committed to fostering growth through ongoing training in the latest industry standards while supporting your professional development in revenue cycle management and electronic health record management. Join us to make a meaningful difference in patient care while advancing your career!
Pay: $25.00 - $30.00 per hour
Work Location: In person