medical billing and collections analyst.

The Medical Billing and Collections Analyst reports to the Manager of Billing and Administration and supports various locations in Cary, NC, Fort Worth, TX, and Clermont, KY. This individual contributor is responsible for accurately and timely processing medically billed claims, researching and resolving claim denials and unpaid balances, supporting collection activities, and completing related invoicing and administrative transactions. The Analyst works closely with Operations, Payer Access, Cash Applications, Account Management, Compliance, and Finance to improve billing accuracy, accelerate reimbursement, maintain effective controls, and support the revenue cycle across Oncology, Rare & Orphan, and Cell & Gene product lines.  Must be able to work Hybrid (Onsite 1 day a week).   Qualifications:

• 3+ years of medical billing, healthcare collections, claims follow-up, denial management, or related accounts receivable experience in a high-volume environment.
• High school diploma or equivalent required; associate or bachelor’s degree in business, finance, accounting, healthcare administration, or a related field preferred.
• Experience working with commercial, government, or other healthcare payers and resolving denied, rejected, or unpaid claims.
• Knowledge of specialty pharmacy, oncology, rare disease, or cell and gene therapy reimbursement is preferred.

Additional Knowledge and Skills

• Working knowledge of medical billing, claim submission, payer follow-up, denial resolution, appeals, reimbursement methods, patient collections, and accounts receivable principles.
• Experience with CPR+, CareTend, WayStar, SAP, payer portals, or comparable pharmacy, billing, and enterprise systems is preferred.
• Ability to interpret explanations of benefits, remittance advice, denial codes, payer policies, account histories, and supporting documentation.
• Advanced analytical and problem-solving skills, including proficiency with Excel spreadsheets, data validation, reconciliations, and trend analysis.
• Ability to maintain confidentiality and handle protected health information and financial information in accordance with applicable requirements.

salary: $34 - $35 per hour
shift: First
work hours: 7 AM - 4 PM
education: High School

Responsibilities

• Prepare, review, and submit medically billed claims through CareTend and WayStar in accordance with payer requirements and established procedures.
• Verify patient, insurance, authorization, coding, and supporting documentation information before claim submission; correct identified errors promptly.
• Monitor claim status, aging, denials, rejections, and underpayments; research root causes and complete timely follow-up, correction, resubmission, reconsideration, or appeal activities.
• Contact payers, patients, and internal partners as appropriate to resolve outstanding balances and document all collection activity accurately.
• Support manufacturer chargeback activities by preparing invoices, submitting required documentation, monitoring payment status, and resolving discrepancies.
• Process billing and invoicing transactions associated with the Exelan VA Lenalidomide program and other assigned programs.
• Reconcile claim, remittance, payment, adjustment, and account information across applicable systems; escalate variances that cannot be resolved within established guidelines.
• Maintain complete and accurate account notes, work queues, appeal records, payer correspondence, and supporting documentation.
• Complete assigned administrative functions, including patient statement distribution, incoming mail review, and routing checks or other payments to the designated lockbox process.

Skills

Credit Collections

Medical Billing

Claims Processing

Insurance Claim Processing

Insurance Verification

Pharmaceutical

Qualifications

Years of experience: 3 years

Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.