Billing Specialist

Job Description

Job Description

General Summary

Hope Health is seeking a Billing Specialist to prepare, submit, and follow up on patient claims across Medicare, Medicaid, commercial, and sliding-fee-scale accounts. This role forms the front line of our revenue cycle, ensuring clean claim submission and accurate patient billing so the health center can sustain the care it provides to the community.

DUTIES & RESPONSIBILITIES

• Prepare, scrub, and submit clean claims to Medicare, Medicaid, and commercial payers in a timely manner.
• Post payments, adjustments, and denials from EOBs/ERAs accurately to patient accounts.
• Verify patient insurance eligibility and benefits prior to and following visits.
• Respond to patient billing inquiries and support sliding-fee-scale documentation and application.
• Reconcile daily/weekly claim batches and identify submission errors before they become denials.
• Coordinate with front-desk and coding staff to correct demographic, coding, or authorization errors.
• Maintain accurate documentation to support monthly billing and QI/QA reporting.

KNOWLEDGE, SKILLS & ABILITIES

• Knowledge of CPT/ICD-10 coding conventions, payer billing rules, and sliding-fee-scale requirements.
• Skill in claim scrubbing, clearinghouse submission, and payment posting with a high degree of accuracy.
• Skill in identifying and correcting demographic, coding, or authorization errors before claims are submitted.
• Ability to communicate billing information clearly and compassionately to patients.
• Ability to maintain productivity and clean-claim-rate standards under routine deadline pressure.
• Ability to work collaboratively with front-desk, coding, and clinical staff to keep claims moving smoothly.

EDUCATION & EXPERIENCE

• 2+ years of experience in medical billing or revenue cycle, preferably in an FQHC or community health setting.
• Working knowledge of CPT/ICD-10 coding, payer billing requirements, and clearinghouse claim submission.
• Experience with practice management or EHR billing systems (e.g., eClinicalWorks, NextGen, or similar).
• Strong attention to detail and comfort working within productivity and clean-claim-rate expectations.
• Certified Billing and Coding Specialist (CBCS) or similar certification a plus, not required.

Job Type: Full-Time

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location: In person, Waxahachie, TX