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About the Role
As the Billing Specialist, you will play a critical role in supporting the revenue cycle at Ally Medical by collaborating with our third-party billing partner to ensure timely and accurate claim processing, account resolution, and payer compliance. You will handle tasks related to insurance follow-ups, medical records, and account reviews with precision and confidentiality. Your attention to detail and commitment to service recovery will directly support our mission of delivering patient-centered care with integrity and excellence.
Responsibilities
- Perform follow-up on coordination of benefits (COB) and insurance ineligibility issues.
- Update patient insurance details and payer IDs to ensure claims are processed correctly.
- Monitor and resolve outstanding claims assigned to Ally Medical through our third-party billing partner.
- Manage cases involving workers’ compensation and attorney representation, ensuring appropriate documentation and timely follow-up.
- Submit necessary corrections or updates to third-party billing workflows to address claim errors or rejections.
- Address deficiencies in medical records required for claim processing.
- Process attorney requests for medical records and affidavits in compliance with privacy regulations.
- Coordinate timely fulfillment of legal documentation required for injury or litigation-related cases.
- Conduct detailed audits of patient statements to ensure billing accuracy.
- Review accounts with high patient balances and escalate as appropriate for resolution.
- Apply approved financial assistance discounts and service recovery adjustments to patient accounts.
- Ensure all patient-facing billing adjustments are well documented and processed in a timely manner.
- Communicate effectively with internal teams and our billing vendor to resolve claim and account issues.
- Maintain accurate and timely documentation for all billing activities and follow-ups.
- Assist in tracking and reporting on billing performance metrics to support process improvement.
- Respond to internal inquiries related to insurance or billing discrepancies.
- Answer inbound phone calls from patients and payers regarding billing inquiries, account balances, insurance questions, and payment options.
- Resolve caller requests on the first contact when possible, and route inquiries that require escalation to the appropriate team member or department in a timely manner.
- Provide a compassionate, professional, and patient-centered experience on every call, consistent with Ally Medical's commitment to delivering care with integrity and excellence.
Requirements
- Comply with all privacy and security laws and internal policies and procedures.
- Play an active role in protecting the company's sensitive data and ensuring patient information is treated with utmost care and confidence.
- Report any concerns or infractions to management.
- Protect provided credentials to access Company networks, systems, and data.
- Maintain the confidentiality of all Ally and customer data.
- Report any suspected compromises of Ally proprietary data or customer data to Management immediately.
- Adhere to the Company’s Information Security Policy and Procedures.
- Support standard operating procedures to protect Company systems and data.
- Alert management immediately with any expected system or data compromises and/or system failure impacting the security, confidentiality, availability, and integrity of Ally Medical and customer data.
- Attend an annual Information Security Awareness Training.
Skills
- Strong understanding of insurance billing practices, COB policies, and denial management.
- Experience with third-party billing coordination and workflow follow-up.
- Familiarity with legal case billing (e.g., WC and attorney involvement).
- High attention to detail and analytical thinking.
- Clear and professional communication skills.
- Proficiency in EMR systems, billing platforms, and Microsoft Office Suite.
- Ability to manage multiple priorities and deadlines in a dynamic work environment.
- Discretion and integrity when handling sensitive patient and financial data.
Experience Level
- Minimum of 2 years of experience in medical billing, preferably in an emergency care or acute care environment
Education Level
- High School Diploma or GED
- Bachelor’s degree in healthcare administration, Accounting, or a related field
About the Company
- Ally Medical's mission is delivering patient-centered care with integrity and excellence.