Billing Specialist

Billing Specialist

The Billing Specialist is responsible for ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and ensuring billing accuracy. This role focuses on precise claim preparation, attention to detail, and proper documentation to minimize errors and maximize clean claim rates. The ideal candidate will have a strong understanding of medical billing practices and payer requirements. This position reports to the Medicaid Billing Manager.

Core Responsibilities:

• Prepare and submit accurate claims in accordance with payer guidelines and customer billing cycles
• Ensure all claim details are complete and error-free, including coding, provider information, and service dates
• Review claims for accuracy and compliance with Medicaid, Medicare, VA, and payer regulations
• Verify correct taxonomy codes, modifiers, and billing procedures to prevent rejections
• Maintain a high clean-claims submission rate by thoroughly reviewing and validating claim information before submission
• Ensure compliance with industry regulations, payer policies, and internal billing procedures
• Maintain accurate and organized billing records and documentation
• Identify and report billing trends, potential errors, and areas for process improvement
• Collaborate with internal teams to standardize billing practices and enhance efficiency
• Support billing audits and internal quality control measures
• Other duties as assigned

Experience and Skills:

• Experience working in billing and health care preferred
• Customer service experience preferred
• Excellent follow-up, time management, and communication skills required
• Proficiency in MS Office Suite (Outlook, Word, Excel) is required

Education and Qualifications:

• High school degree required

What We Offer:

• Medical, dental, and vision benefits
• 401k retirement plan
• Aflac benefits
• Paid time off
• Professional development support

Compensation:

$55,000-$65,000 depending on experience