Billing and Collections Specialist

The Billing and Collections Specialist has the important role of managing the full lifecycle of patient accounts for Enara Health's obesity and weight loss program. You will be responsible for ensuring insurance verification, accurate billing, proactive denial management, and payment posting. The ideal candidate will demonstrate excellent communication skills, a deep understanding of healthcare billing practices, and a patient-centered approach.

Claims & Billing Management

• Manage billing within the practice management system, focusing on working draft invoices and resolving rejections.

• Perform final reviews for duplicate claims and manage the accurate export of billing data.

• Handle Remote Patient Monitoring (RPM) submissions to ensure timely reimbursement.

• Review billing data for completeness and accuracy and ensure all provider notes are signed.

Eligibility & Membership Management

• Call insurance companies to verify eligibility and benefits for new leads, utilizing portals such as OneSource and Availity.

• Activate new accounts in the patient account management system for membership switches.

• Review and collect patient balances in the practice management system.

• Identify cases requiring authorization, compile medical records, and submit requests via portal or fax.

Collections & Payment Posting

• Process payments and refunds and inform patients of overdue balances.

• Focus on account escalations, working large balances, and clearing payer blockers to ensure consistent cash flow.

• Review and complete auto-posted payments in the practice management system, ensuring SFTP remit files and EOBs are properly reconciled daily.

Education:

• High school diploma or GED required; Associate or Bachelor’s degree in Healthcare Administration, Finance, or a related field preferred.

Experience:

• Proven experience in Revenue Cycle Management (RCM), patient collections, or medical billing/coding, preferably supporting a specialized healthcare program.

Skills:

• Skilled in using an Electronic Medical Record (EMR), practice management system, payer portals, and a comprehensive understanding of insurance verification and eligibility. 

• Strong ability to perform root-cause analysis on denials and resolve complex billing discrepancies.

Attributes:

• Excellent professional communication skills for frequent interaction with insurance companies, patients, and internal provider teams.

• High level of professionalism, patience, and empathy when working with patients on sensitive financial issues.

• Ability to support occasional weekend coding tasks or approved overtime to meet critical submission deadlines.