Medical Accounts Receivable Billing Specialist

As a recognized Hemophilia Treatment Center and a Center of Excellence, the Washington Institute for Coagulation d/b/a Washington Center for Bleeding Disorders (WACBD), is committed to the wellbeing of patients with an inherited bleeding disorder across the State of Washington, neighboring states, and Alaska.Our staff is an ensemble of dedicated healthcare professionals and support personnel that are striving to ease the burden that bleeding disorders have placed upon our patients.The PositionThe Medical Accounts Receivable Billing Specialist, reporting directly to the Revenue Cycle Manager, is responsible for managing and resolving insurance and patient accounts receivable, and ensuring accurate and timely billing, reimbursement, and collections. This role supports WACBD's financial health by monitoring outstanding balances, communicating with patients and payers, and maintaining meticulous documentation in accordance with organizational policies and healthcare regulations.This position requires strong analytical skills, attention to detail, and a commitment to delivering exceptional service to patients with chronic and complex medical needs.Key ResponsibilitiesReview and monitor accounts receivable aging reports to identify outstanding balances and prioritize follow-up activities.Work complex denials (coding, medical necessity, eligibility, prior auth, duplicate, bundling, coordination of benefits) and submit appeals to secure reimbursement.Contact insurance companies to verify claim status, resolve payment issues, and request claim reprocessing when necessary.Post, reconcile, and verify insurance payments accurately.Communicate with patients regarding insurance eligibility, out-of-pocket costs, and benefits.Reconcile remittance advice (ERA/EOB), post payments and adjustments, resolve under/overpayments, and escalate variances.Collaborate with internal departments to resolve billing and reimbursement issues.Partner with management to discuss and report on trends in denials, performance, and insurance payers.Maintain detailed and accurate records of all account activity, follow-up efforts, and correspondence in the billing system.Collaborate with Revenue Integrity/Coding to correct charge capture and coding issues; contribute to process improvements and SOP updates. RequirementsA minimum of (2) years of hands-on experience in medical billing and A/R, specifically managing claim follow-up, denials, appeals, and payment posting with certification or,A minimum of (5) years of hands-on experience in medical billing and A/R, specifically managing claim follow-up, denials, appeals, and payments in lieu of certification.In-depth knowledge of medical terminology, CPT, ICD-10, and HCPS coding principlesProficiency with clearinghouses, payer portalsDemonstrated success improving A/R metrics (e.g., reducing DSO, increasing first-pass yield).Strong understanding of payer policies, guidelines, and regulations for commercials, government (CMS), and third-party payers.Strong analytical, problem-solving, and written communication skills; able to craft effective appeals with supporting documentation.Prior experience in Microsoft Office, EHR, and practice management systems requiredSkillsInsurance claims follow-upDenial management and appealsAccounts receivable analysisPost payment and reconciliationCustomer service and patient communicationAttention to detailTime managementProfessional QualificationsHigh degree of integrity, professionalism, and ethical conduct.Unwavering commitment to maintain strict patient confidentiality and adhere to all HIPAA regulations.Excellent written and verbal communication skills, with the ability to articulate complex information clearly and concisely.Cultivate diversity and respect.Preferred Qualifications340b Pharmacy billingSpecialized Expertise- Active CPC, CPC-A, CPB, or CRCR.Associate degree or higher in business, finance, or healthcare-related studiesPrior EHR experience in Nextgen, R2, Newleaf/Keycentrix, and related Pharmacy Billing Software.Work EnvironmentFull-time, Monday–Friday. Hybrid/remote options based on department policy.Ability to sit or stand at the workspace to work on the computer and telephone.Occasional overtime during month-end close or audits.