Facility Billing Specialist

SUMMARY:

This position is responsible for ensuring the accuracy of facility invoicing through internal audit processes, maintaining a thorough working knowledge of facility contracts and obligations, and understanding correct billing procedure as it pertains to facility responsibility. This role is responsible for billing facilities in accordance with contract terms, monitoring outstanding balances through regular review of the aging report, and following up proactively to secure timely payment on facility accounts.

ESSENTIAL DUTIES AND RESPONSBILITIES:   (Responsibilities include, but not limited to)

• Reviews all facility invoices for accuracy against negotiated rates and contract provisions prior to invoicing, ensuring billed amounts, service dates, and volumes reconcile to the underlying contract terms.
• Maintains a working knowledge of each assigned facility contract, including rate schedules, billing frequency, invoicing requirements, payment terms, and any facility-specific billing stipulations or exceptions.
• Applies contract terms correctly when generating invoices, and escalates discrepancies between contracted rates and billed amounts for resolution prior to submission.
• Reviews and bills claims that were denied by the primary payer, determining facility responsibility in accordance with contract terms.
• Prepares and sends out monthly facility invoicing in accordance with each contract's billing schedule and required format.
• Regularly reviews the aging report to identify past-due facility accounts, prioritizing follow-up based on balance size, age, and contract payment terms.
• Conducts proactive, ongoing follow-up with facilities on outstanding balances, via phone and written correspondence, to secure timely payment and resolve any billing disputes.
• Documents all collection and follow-up activity on facility accounts, including payment commitments, disputes, and resolution status.
• Identifies accounts with recurring payment delays or disputes and escalates to the Billing Manager.
• Responds to facility inquiries regarding invoices, balances, and contract terms in a timely and professional manner.
• Updates rates and billing parameters in the billing system per contract specifications, ensuring changes are applied accurately and effective as of the correct contract date.
• Adheres to company policies and procedures.
• Other duties as assigned.

KNOWLEDGE AND SKILLS:

• Ability to read, analyze, and interpret facility contracts and insurance plans.
• Possesses intermediate knowledge of Medicare, Medicaid, and insurance benefits.
• Strong understanding of contract-based billing principles, including rate application, billing cycles, and facility payment terms.
• Skilled in reviewing and interpreting aging reports to prioritize collection follow-up and identify at-risk accounts.
• Must have accurate, high-level data entry skills with continuous quality focus.
• Must have excellent phone and customer service skills, including the ability to professionally manage payment follow-up conversations with facility contacts.
• Must be detail-oriented with excellent organizational and problem-solving skills.
• Experience in MS Office and general computer skills, including proficiency with billing system rate tables and aging/collections reporting tools.
• Regular attendance is an essential function of the position.

PHYSICAL REQUIREMENTS:

• Works around standard office conditions, repetitive use of a keyboard at a workstation, and use of manual dexterity. Frequent use of manuals and other resources. Work in shared office space and sits for long periods of time.

MINIMUM QUALIFICATIONS:

• High School Graduate or equivalent.
• Minimum of 9 months experience in a medical office setting
• Prior experience with contract-based billing, facility billing, or collections/aging follow up preferred

Other duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.  Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Allegiance is an EEO employer as defined by the EEOC.