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

• 2–4 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
• 2–4 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.

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 management’s 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.

Join PACS: Elevate Healthcare with Us!

PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and fun, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide.

If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let’s shape the future of healthcare!

Join Our Team and Thrive!

At PACS, we believe our employees are our greatest asset. That’s why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.

Our Comprehensive Benefits Include
 

• Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
• PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
• Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
• Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
• Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.
   

Join us at PACS and take advantage of a workplace that truly values you!

PACS is 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.