About Legent Health
At Legent Health, our mission is simple yet profound: “To provide first-class health care that puts YOU first.”
Our vision reflects our commitment to excellence: “Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone.”
Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do:
- Respect: We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience.
- Service: We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all.
- Leadership: We strive to be a trusted leader through innovation, clear communication, and unwavering dedication to excellence across our employees and partners.
Joining Legent Health means being part of a team that lives these principles every day, as we build a future focused on compassionate, quality care.
About the Role We are seeking an experienced Billing and Payment Resolution Specialist to join our supporting high-volume imaging and physical therapy operations. This critical role involves overseeing billing charges, ensuring seamless claims transmission to clearinghouses and payors, performing accurate payment posting, and resolving payment discrepancies. The successful candidate will collaborate with our early out program leader to ensure optimal revenue cycle operations. The ideal candidate will possess advanced proficiency in radiology and PT-focused billing platforms and professional-level experience in revenue cycle management.
POSITION’S ESSENTIAL RESPONSIBILITIES:
- Review and validate billing charges for accuracy, completeness, and compliance with coding guidelines and payer requirements across high-volume imaging studies and physical/occupational therapy service lines
- Ensure timely and accurate charge capture for diagnostic imaging procedures (MRI, CT, X-ray, ultrasound) and therapy visit services
- Monitor charge lag reports and collaborate with clinical and front desk staff to resolve missing or incomplete charges in high-volume, multi-location environments
- Notify early out program leader of charge description master (CDM) updates and pricing discrepancies
- Perform daily charge reconciliation and exception reporting
- Submit claims electronically through clearinghouses to various payors (commercial, Medicare, Workers Comp)
- Monitor claims transmission reports and resolve transmission errors
- Track claim status from submission through adjudication
- Manage claim edits, rejections, and clearinghouse error resolution
- Maintain clean claim rates above 98% through systematic pre-submission validation
- Post payments accurately from electronic remittance advice (ERA) and paper EOBs
- Reconcile daily cash receipts and identify payment variances
- Process contractual adjustments, write-offs, and refunds according to established procedures
- Maintain payment posting accuracy above 99%
- Generate and analyze payment reports for management review
- Handle claim rejections and edits at the clearinghouse level before transmission to payors
- Research and resolve payment discrepancies and short payments for routine claims
- Research and resolve unidentified payments from insurance and patient sources, coordinate with patient access and billing teams to locate appropriate accounts and ensure timely clearing of payment suspense items to support accurate month-end financial reporting
- Process initial claim corrections and resubmissions through clearinghouse systems
- Collaborate with AR specialist for high-level accounts receivable issues requiring advanced resolution
- Maintain detailed documentation of all front-end resolution activities
- Escalate complex denial patterns and unresolved payment issues to AR specialist
- Track and report rejection trends and initial resolution rates
POSITION REQUIREMENTS:
- Strong analytical and problem-solving abilities
- Excellent attention to detail and accuracy
- Understanding of healthcare reimbursement methodologies including radiology fee schedules and therapy cap/KX modifier rules
- Effective written and verbal communication skills
- Ability to work independently and manage multiple priorities
- Customer service orientation for patient and payer interactions
- Understanding of healthcare reimbursement methodologies
- Knowledge of regulatory requirements affecting billing operations
EDUCATION AND EXPERIENCE REQUIREMENTS:
- High school diploma or GED required; Associate's degree in Health Information Management, Healthcare Administration, or related field preferred
- Current certification preferred: CPB (Certified Professional Biller) from AAPC or CRCR (Certified Revenue Cycle Representative) from HFMA
- Minimum 3-5 years of healthcare billing experience in high-volume imaging (radiology, MRI, CT, ultrasound) and/or physical/occupational therapy environments
- Demonstrated professional-level experience with Waystar revenue cycle management platform
- Experience with HST Pathways software preferred
- Experience with multiple payer types including commercial, Medicare, and Workers Comp
- Advanced proficiency in healthcare revenue cycle management systems
- Strong knowledge of medical coding (CPT, ICD-10, HCPCS)
- Experience with electronic claim submission and clearinghouse operations
- Proficient in Microsoft Office Suite, particularly Excel for data analysis
- Ability to navigate multiple software systems simultaneously
- Experience with electronic remittance advice (ERA) processing
Why Join Legent Health?
Legent Health fosters an environment where team members are empowered to deliver exceptional care while growing professionally within a supportive, values-driven culture.
We Offer:
- Competitive salary and performance incentives
- Comprehensive benefits package
- Paid time off and wellness programs
- Career development and training opportunities
Equal Employment Opportunity (EEO) Statement
Legent Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, disability status, or any other legally protected characteristic.
I-9 and E-Verify Compliance:
Employment eligibility will be verified through the U.S. Department of Homeland Security’s E-Verify system. All applicants must provide valid documentation to establish identity and authorization to work in the United States, as required by federal law.
Similar Jobs
What you need to know about the Austin Tech Scene
Key Facts About Austin Tech
- Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
- Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
- Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
- Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center
