Billing Specialist

The Billing Specialist is responsible for ensuring Valley View Health Center (VVHC) claims are accurately submitted, processed, posted, and resolved in a timely manner. This role manages all aspects of medical billing on behalf of VVHC, including claim submission, denial follow-up, payment posting, accounts receivable management, and patient billing support. The Billing Specialist plays a critical role in maintaining cash flow, billing compliance, and positive patient financial experiences. Claims Processing, Billing, and Accounts Receivable Estimated Effort: 98% Provide excellent customer service by assisting patients in understanding billing statements, charges, insurance coverage, and payment responsibilities, including establishing payment arrangements as needed. Work directly with insurance companies, providers, and patients to ensure claims are processed and paid accurately and timely. Submit claims electronically through the current practice management system and clearinghouse. Correct and resubmit any rejected or denied claims by the end of the following business day whenever possible. Ensure all claims are submitted accurately and within required timeframes. Follow up on claim denials and rework or resubmit claims as necessary to ensure proper reimbursement. Maintain accurate accounts receivable records, including logging payments from insurance companies and patients and maintaining current balances. Monitor aging accounts receivable and prioritize follow-up on claims reaching 30 days or older. Verify insurance eligibility and rebill insurance companies as required. Reconcile remittance advices and scan Explanation of Benefits (EOBs). Process employee deductions on a bi-weekly basis as assigned. Assist in preparing documentation for refunds to patients or insurance companies. Generate and mail patient statements according to established billing cycles and procedures. Collaboration and Support Estimated Effort: 2% Attend meetings, conferences, and training related to billing, claims processing, and revenue cycle operations and share relevant information with appropriate staff. Serve as a representative of the Fiscal Department on assigned CAC committees. Assist with tasks that support the organizations mission, vision, and values. Serve as a backup for Medical and Dental Patient Access Representatives as needed. Minimum Requirements Education: High School Diploma or equivalent. Job-Related Experience: Minimum of six (6) months of training with a computer and bookkeeping background At least one (1) year of experience working in a medical billing setting Minimum of one (1) year of experience operating personal computers Typing speed of 30 keystrokes per three (3) minutes with a maximum of three (3) errors Preferred Qualifications Experience working in a Federally Qualified Health Center (FQHC) setting Working Conditions This position operates in a well-lighted office environment. Occasional local or regional travel may be required for meetings, conferences, or training sessions. Work is fast-paced and deadline-driven and involves managing multiple priorities. The role generally involves low-to-moderate levels of stress.