Billing Representative

Job Summary

Working remotely in a full-time capacity, the Billing Representative II will analyze and resolve complex billing issues, manage third-party insurance claims, and ensure compliance with departmental procedures while contributing to revenue collection efforts.

Key responsibilities

• Analyze and apply denials to third-party carriers and interpret explanations of benefits for follow-up actions
• Utilize automation tools to verify eligibility and claim status while creating worklists to analyze trends for claim resolution
• Communicate with members or providers to evaluate claims errors and meet established performance goals for efficiency and accuracy

Required qualifications

• High School Diploma/GED or equivalent work experience
• Demonstrated proficiency with computer and Windows PC applications, including Outlook and Excel
• Strong keyboard and navigation skills with the ability to learn new computer programs
• Must have a dedicated work area that ensures information privacy and secure handling of sensitive documents
• Ability to maintain a high-speed internet connection suitable for remote work