Healthcare Billing Specialist (ASC Billing)

• Manage full-cycle

including claims preparation, submission, tracking, follow-ups, denials, appeals, and reimbursement resolution.

• Prepare, review, and submit claims for outpatient surgical procedures, ensuring accuracy and compliance with payer requirements.

• Apply knowledge of

to identify potential claim errors.

• Verify that surgical claims include accurate procedure information, appropriate modifiers, and required supporting documentation.

• Navigate Medicare, Medicaid, and commercial insurance billing requirements applicable to ASC services.

• Review payer-specific reimbursement guidelines, including applicable ASC payment methodologies.

• Investigate rejected, denied, underpaid, or unpaid surgical claims and determine appropriate corrective actions.

• Process corrected claims, reconsiderations, and appeals to resolve reimbursement discrepancies.

• Manage accounts receivable (AR) and follow up on outstanding ASC claims.

• Identify coding-related discrepancies, missing documentation, and potential reimbursement issues.

• Verify patient insurance eligibility, coverage, and benefits before claim submission when needed.

• Coordinate with insurance representatives and internal teams to resolve billing concerns.

• Ensure claims are accurate, complete, and compliant with applicable payer requirements.

• Meet the daily productivity target of

• Upload, track, organize, and maintain Explanation of Benefits (EOBs).

• Maintain accurate records of submitted, pending, denied, corrected, and resolved claims.

• Assist with home health agency billing and revenue cycle management as needed.

• Review and process

for accuracy, completeness, and timely submission.

• Support home health claims submission, insurance follow-ups, and denial resolution.

• Utilize

for billing, documentation, and claim tracking when applicable.

• Ensure home health billing activities follow applicable payer requirements.

• Maintain accurate documentation and records of home health billing activities.

• Prepare and maintain billing reports, spreadsheets, claims trackers, and documentation.

• Assist with administrative overflow and other operational responsibilities.

• Provide executive and administrative support to ensure smooth daily operations.

• Maintain organized records and communicate outstanding tasks or concerns promptly.

• Support workflow improvements to increase billing efficiency and accuracy.

• Answer and manage inbound and outbound calls using

• Respond to patient inquiries professionally, accurately, and promptly.

• Provide receptionist-level support when needed.

• Communicate with patients, insurance representatives, and internal staff regarding billing-related inquiries.

• Maintain patient confidentiality and provide professional, empathetic communication.

A successful Healthcare Billing Specialist consistently demonstrates:

• Accurate and timely ASC claims submission.

• Strong knowledge of outpatient surgical billing requirements.

• Effective resolution of denied, rejected, and underpaid ASC claims.

• Consistent management of accounts receivable and outstanding reimbursements.

• Achievement of the daily KPI of 45 claim follow-ups.

• Accurate application of relevant CPT/HCPCS codes, modifiers, and payer requirements.

• Organized and complete EOB documentation and claims tracking.

• Proactive identification of billing errors and reimbursement discrepancies.

• Reliable administrative support and professional patient communication.

• Consistent compliance with HIPAA and healthcare billing policies.

• ALORA

• eClinicalWorks (eCW)

• AdvancedMD

• DrChrono

• WebPT

• Fair Bill

• Elation

• TheraBill

• Nextiva VoIP

• Strong understanding of ASC billing workflows, outpatient surgical claims, and revenue cycle management.

• Experience preparing, submitting, tracking, and following up on ASC claims.

• Working knowledge of

• Familiarity with Medicare and commercial insurance billing requirements for outpatient surgical procedures.

• Experience managing denied, rejected, underpaid, and unpaid medical claims.

• Hands-on experience with accounts receivable, insurance follow-ups, claim corrections, and appeals.

• Ability to identify billing discrepancies, coding-related errors, missing documentation, and reimbursement issues.

• Experience verifying insurance eligibility, coverage, and benefits.

• Familiarity with EOBs, payment discrepancies, and claims tracking.

• Ability to maintain accurate records and meet daily productivity targets.

• Strong understanding of payer-specific billing requirements and reimbursement guidelines.

• Excellent attention to detail, analytical thinking, and problem-solving skills.

• Strong organizational and multitasking abilities.

• Excellent written and verbal English communication skills.

• Ability to work independently, manage competing priorities, and adapt to changing workflows.

• Knowledge of HIPAA compliance and patient confidentiality requirements.

• Experience supporting multiple Ambulatory Surgery Centers or outpatient surgical specialties.

• Familiarity with ASC Medicare payment methodologies and commercial payer reimbursement processes.

• Experience resolving complex ASC denials, underpayments, and coding-related reimbursement discrepancies.

• Knowledge of surgical procedure coding and applicable modifiers.

• Experience with home health agency billing and

• Familiarity with

or other home health billing platforms.

• Experience using eClinicalWorks, AdvancedMD, DrChrono, WebPT, Fair Bill, Elation, or TheraBill.

• Experience using Nextiva or similar VoIP systems.

• Previous experience supporting U.S.-based healthcare billing organizations remotely.

• Experience providing administrative, executive, or patient reception support.

Effectively manages outstanding claims, follow-ups, and deadlines.

• Pr

Consistently meets billing follow-up targets without compromising accuracy.

• A

• Must be proficient in speaking and writing clear, professional English.

• Must have relevant hands-on experience in U.S. medical billing, particularly ASC billing.

• Must be able to submit an

before onboarding (mandatory).

• Must be available for video meetings with camera on when required.

• Must be available to work full-time, Monday through Friday, from 9:00 AM to 6:00 PM Eastern Time.

• Computer: Reliable laptop or desktop computer.

• Internet: Stable high-speed internet connection (minimum 25 Mbps).

• Audio: Noise-canceling headset.

• Video: Working webcam for virtual meetings.

• Workspace: Quiet and professional work environment.