Billing Assistant

About the Role:

The Billing Specialist plays a critical role in the organization by ensuring accurate and timely processing of patient billing and insurance claims. This position is responsible for managing billing cycles, verifying patient information, and collaborating with insurance providers to resolve discrepancies. The Billing Specialist contributes to the financial health of the organization by minimizing billing errors and optimizing revenue collection. They serve as a key liaison between patients, healthcare providers, and insurance companies to facilitate clear communication and efficient billing operations. Ultimately, this role supports the organization's mission by maintaining compliance with healthcare regulations and delivering exceptional service to patients and stakeholders.

Minimum Qualifications:

• High school diploma or equivalent; associate degree in healthcare administration or related field preferred.
• Minimum of 3 years experience in medical billing or healthcare revenue cycle management.
• Proficiency with medical billing software and electronic health record (EHR) systems.
• Strong understanding of medical terminology, insurance policies, and billing codes (e.g., CPT, ICD-10).
• Excellent attention to detail and organizational skills.

Preferred Qualifications:

• Certification as a Certified Professional Biller (CPB) or similar credential.
• Experience working within the healthcare and social assistance industry.
• Familiarity with HIPAA regulations and patient privacy standards.
• Advanced knowledge of insurance claim adjudication and denial management.
• Strong customer service skills with experience handling sensitive patient information.

Responsibilities:

• Prepare and submit accurate patient invoices and insurance claims in accordance with healthcare regulations and organizational policies.
• Review and verify patient billing information, including insurance coverage, coding accuracy, and payment details.
• Follow up on unpaid or denied claims by communicating with insurance companies and patients to resolve issues promptly.
• Maintain detailed records of billing transactions, adjustments, and correspondence to ensure transparency and audit readiness.
• Collaborate with healthcare providers and administrative staff to clarify billing questions and improve billing processes.
• Stay current with changes in healthcare billing regulations, insurance policies, and coding standards to ensure compliance.
• Assist patients with billing inquiries, providing clear explanations and support to facilitate timely payments.

Skills:

The Billing Specialist utilizes their knowledge of medical terminology and billing codes daily to accurately process claims and invoices, ensuring compliance with healthcare regulations. Proficiency in billing software and EHR systems enables efficient management of patient data and billing records. Strong communication skills are essential for interacting with patients, insurance providers, and healthcare staff to resolve billing issues and clarify information. Attention to detail is critical in reviewing claims and identifying discrepancies to prevent revenue loss. Additionally, problem-solving skills help the specialist navigate complex insurance policies and denial management to optimize reimbursement.