Billing Specialist

Position Title Billing Specialist Department Revenue Cycle Nature of Position The Billing Specialist will research and review accounts to assure accurate patient balances, set up payment plans, and conduct follow-up on accounts. Minimum Qualifications High school graduate or equivalent required Ability to work and communicate with a multidisciplinary health‑care team Ability to understand insurance terms, payment methodologies, and effectively negotiate with customers when required Must be familiar with medical terminology Ability to work in a fast‑paced, high‑volume, high‑stress environment Must be able to sit, stand, walk, bend, and/or lift for extended periods of time Responsibilities Prepares and submits accurate insurance claims (electronic and paper) to commercial, Medicaid, Medicare, and other third‑party payers. Monitors claim status and follows up on unpaid, denied, or rejected claims in a timely manner. Investigates and resolves claim denials, rejections, and payment discrepancies. Prepares and submits corrected claims, appeals, and supporting documentation as needed. Posts insurance payments, adjustments, and explanations of benefits (EOBs) accurately to patient accounts. Communicates with insurance companies to resolve billing issues and obtain claim status updates. Works closely with providers, coding staff, and office personnel to resolve billing and documentation issues. Identifies trends in denials or underpayments and reports issues to management. Maintains up‑to‑date knowledge of payer requirements, policies, and regulatory changes. Ensures compliance with all federal, state, and payer‑specific regulations, including HIPAA. Maintains accurate and complete documentation of all billing activities in the EHR/EPM system. Meets productivity and quality standards for claim submission, follow‑up, and resolution. Participates in ongoing training and education related to billing, coding, and compliance. Performs other duties as assigned. #J-18808-Ljbffr