[Hiring] Patient Engagement & Billing Specialist @Monte Nido & Affiliates, LLC

Role Description

The Patient Engagement & Billing Specialist plays a critical role within the Revenue Cycle Management (RCM) team by serving as the primary liaison between the healthcare organization and its patients regarding billing and financial inquiries. This role is responsible for delivering clear, compassionate, and timely communication related to patient balances, insurance coverage, and payment options, including financial assistance programs. Through proactive engagement and meticulous account management, this position contributes to enhanced patient satisfaction and optimized revenue collection.

• Communicate professionally and empathetically with patients via phone and email regarding outstanding balances, billing questions, and account resolution.
• Manage inbound and outbound patient calls through the Vonage queue, ensuring timely follow-up and resolution.
• Review patient accounts for accuracy and explain charges, payments, denials, and adjustments in a clear and understandable manner.
• Educate patients on insurance benefits, coverage limitations, co-payments, deductibles, and overall financial responsibility.
• Assist patients in establishing payment plans and applying for financial assistance programs when eligible.
• Collaborate closely with internal departments, including coding, insurance verification, and collections, to resolve account discrepancies.
• Accurately document all patient interactions and actions taken in the KIPU/CMD EMR system in compliance with HIPAA and organizational standards.
• Identify trends or recurring issues in patient billing inquiries and recommend process improvements to leadership.
• Maintain current knowledge of payer policies, billing regulations, compliance standards, and system updates.

Qualifications

• 5+ years of relevant experience and a college degree preferred or an equivalent combination of education.
• Minimum of 5 years of experience in medical billing, financial clearance, or a related revenue cycle role.
• Behavioral health experience preferred.
• Experience with CMD/KIPU EMR or practice management systems preferred.
• Salesforce experience preferred.
• Strong understanding of HIPAA regulations and the proper handling of Protected Health Information (PHI).
• Working knowledge of insurance policies, billing procedures, and claim terminology.
• Proven ability to communicate effectively with diverse patient populations.
• Exceptional organizational, analytical, and problem-solving skills.
• Strong understanding of healthcare billing concepts, including:
• Explanation of Benefits (EOBs)
• HCPCS
• Revenue codes
• CPT and ICD-10 codes
• Financial assistance programs
• Excellent written and verbal communication skills with a customer-first mindset.
• In-depth knowledge of insurance guidelines, medical terminology, and CPT/ICD-10 coding.
• High attention to detail and strong time-management skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Effective problem-solving and conflict-resolution abilities.
• Proficiency in Microsoft Office Suite and healthcare billing and EMR systems.

Benefits

• Competitive compensation
• Medical, dental, and vision insurance coverage
• Retirement
• Company-paid life insurance, AD&D, and short-term disability
• Employee Assistance Program (EAP)
• Flexible Spending Account (FSA)
• Health Savings Account (HSA)
• Paid time off
• Professional development
• And many more!