Billing Specialist, Provider Services (eCW)
New
P
PavagoMedical billing
Costa Rica. Panama. Colombia. Honduras. El Salvador. Mexico, Must overlap with U.S. Mountain Time business hours for at least 4 hours per dayFull-TimeMiddle
Salary not disclosed
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Job Details
- Languages
- Strong written and spoken English.
- Experience
- 5+ years of professional claims billing experience for physician practices; at least 2 years of experience leading or managing a billing team.
- Required Skills
- Microsoft ExcelHIPAA
Requirements
- Have 5+ years of professional claims billing experience for physician practices, including CMS-1500 and 837P claims.
- Have at least 2 years of experience leading or managing a billing team.
- Bring expert, hands-on eCW billing experience, including claim screens, work queues, payment posting, and billing reports.
- Know Medicare Part B, Medicare Advantage, Medicaid, and commercial payer billing.
- Understand payer timely filing requirements, reopenings, redeterminations, and appeal processes.
- Have measurable experience reducing aged accounts receivable backlogs.
- Be able to read and interpret ERAs and CARC/RARC codes.
- Have strong Excel skills and clear written and spoken English.
- Complete HIPAA training, sign a business associate agreement with Pavago, and pass a background check.
- Overlap with U.S. Mountain Time business hours for at least 4 hours per day.
Responsibilities
- Assign billing work queues and practices to designated billers, review daily productivity, and follow up on performance gaps.
- Lead weekly billing team meetings and one-on-one check-ins; train, coach, and support billers while maintaining accountability.
- Manage current claims and claims over 90 days old, prioritizing aged accounts receivable by timely filing requirements and appeal deadlines.
- Monitor claims and outstanding balances, and improve clean claim submission and overall billing performance.
- Oversee daily denial management, maintain a denial trend log, and address recurring denial patterns through eCW rules, workflow improvements, and front-end fixes.
- Oversee corrected claims, reopenings, redeterminations, appeals, and resolution of complex billing issues.
- Oversee payment posting, including $0 remits, zero-payment ERAs, payer recoupments, and takebacks.
- Review and prepare write-off requests with documented collection efforts, and drive month-end close cutoffs.
- Troubleshoot eCW billing issues, coordinate with the eCW vendor team, and review daily and weekly reports.
- Lead agency billing review calls and communicate progress, challenges, results, and performance trends.
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