Billing Rep II

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.  

As our Billing Specialist, you will help the Billing department straighten up claims and prepare them to be submitted so that they can be sent out to various insurance payers, ensuring timely reimbursement. Every day you will, verify benefits, complete authorizations for specialty items using Medicare/Medicaid systems. Return workorders to the specialty shops for billing.  Will follow up with various insurance payers to ensure claims are billed correctly and in compliance with all relevant regulations and payer requirements.  Must know the difference between purchased and rental equipment and how authorizations for both are processed. To thrive in this role you must, have a strong background durable medical equipment and understand how it is billed.  Must have good communications skills, verbal and written and the ability to work with patients.  

Here’s what you will experience working as a Billing Specialist II: 

• You will review, correct, and finalize claims to ensure accuracy before submission. 

• Efficiently process and send out claims to various insurance payers, ensuring timely reimbursement. 

• You will utilize EPIC software for managing hospital billing processes and maintaining accurate patient records. 

• You will handle billing for wheelchairs and other specialty items, ensuring compliance with all relevant regulations and payer requirements. 

• Conduct thorough edits on UB-04 claims to ensure they meet payer-specific guidelines and standards. 

What we are looking for:  

• Proven experience in hospital billing, particularly with specialty items like wheelchairs, crutches etc. 

• Strong understanding of insurance payer websites along with experience billing Medicaid and or Medicare claims. 

• In-depth knowledge of Medicare billing processes and familiarity with the DDE system. 

Required Skills: 

• High School Diploma or equivalent (GED) 

• 2 years of acute hospital billing