Regional Billing Specialist

General Purpose The Regional Billing Specialist is responsible for ensuring the accuracy, integrity, and efficiency of accounts receivable processes across the designated region. This role serves as a technical expert and oversight mechanism to maximize collections and minimize aging through proactive claims management and adherence to payer regulations. Essential Duties Claims Management & Billing Accuracy Trial Claims: Generate trial claims regularly to identify and resolve billing errors prior to final submission. Billing Cycle Oversight: Ensure all prior-month claims are billed immediately following the Triple Check date. Unbilled Claims Management: Maintain a cumulative list of all unbilled claims; provide daily updates and documentation until all prior-month claims are successfully released. Clearinghouse Maintenance: Review Waystar for rejected claims daily. Ensure all rejections are corrected and resubmitted within one business day. Payer Compliance & Revenue Integrity Contractual Expertise: Maintain comprehensive working knowledge of payer contracts and rules; ensure all billing aligns strictly with specific contract provisions. Payer Sequencing: Review Payer Setup Information reports regularly to identify inaccuracies. Execute corrections or direct Business Office Managers to resolve errors via the collection note process. Denial Management: Monitor insurance portals for status updates and denials. Execute immediate corrections or submit formal appeals as appropriate to secure payment. Collections & Cash Application Collection Module Oversight: Monitor the PointClickCare Upcoming Activity Tab. Review outstanding accounts, initiate new activities, and provide direct feedback/notes to BOMs within the module. Account Documentation: Ensure detailed, professional notes are added to all accounts worked within PCC to maintain a clear audit trail. Cash Posting & Reconciliation: Post all payer-appropriate cash to PCC daily. Perform regular reconciliations between bank deposits and PCC postings to ensure financial data integrity. Reporting & Analysis Trend Identification: Analyze accounts receivable aging reports to identify negative trends or systemic issues. Management Reporting: Keep executive leadership informed by providing concise summaries and actionable insights regarding the region's financial health. Supervisory Requirements This role has no supervisory requirements. Qualification Education and/or Experience 24 years of experience in healthcare billing, accounts receivable, or revenue cycle operations. Working knowledge of payer rules, billing regulations, and claims submission processes. Experience with electronic health record (EHR) and billing platforms (PointClickCare or similar). Strong analytical skills with the ability to identify trends, resolve billing issues, and ensure data accuracy. Excellent attention to detail, documentation habits, and organizational skills. Ability to communicate effectively with Business Office Managers, payers, and cross-functional teams. Key Competencies Technical Proficiency: Advanced knowledge of PointClickCare and Waystar (or similar clearinghouses). Professionalism: Demonstrate high levels of autonomy, organization, and assertiveness when addressing billing discrepancies. Adaptability: Exhibit flexibility and a cooperative spirit in a fast-paced, multi-facility environment Physical Demands 24 years of experience in healthcare billing, accounts receivable, or revenue cycle operations. Working knowledge of payer rules, billing regulations, and claims submission processes. Experience with electronic health record (EHR) and billing platforms (e.g., PointClickCare, Waystar or similar). Strong analytical skills with the ability to identify trends, resolve billing issues, and ensure data accuracy. Excellent attention to detail, documentation habits, and organizational skills. Ability to communicate effectively with Business Office Managers, payers, and cross-functional teams. Salary Range: $80,000 - $100,000 annually Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually low to moderate. Additional Information Note: Nothing in this job specification restricts managements right to assign or reassign duties and responsibilities to this job at any time. Critical features of this job are described under various headings above. They may be subject to change at any time due to reasonable accommodation or other reasons. The above statements are strictly intended to describe the general nature and level of the work being performed. They are not intended to be construed as a complete list of all responsibilities, duties, and skills required of employees in this position. We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other legally protected status. PACS is revolutionizing the delivery and leadership of post-acute healthcare and support services across the country. Originally founded in 2013, the organization now consists of hundreds of independent operating subsidiaries, as well as ancillary and support services. We bring a proven model of mission-driven care that balances access to a national network of support and resources with local decision making. In addition, PACS helps connect exceptional people with premier healthcare careers across the country. We focus on finding innovative and effective team members based on their qualifications, experience, geographic preferences, and personality fit with the existing facility staff and culture. We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.