Medical Billing Specialist

Position Summary University Program Associate – Medical Billing Specialist Location: Boone, NC Department: Appalachian Institute for Health and Wellness (273600) Employment Type: Permanent Full-Time Salary Range: $48,004 - $50,530 Visa Sponsorship: Not available Primary Responsibilities Claims submission: Prepare, review, and transmit claims to insurance companies (commercial and government). Revenue cycle management: Monitor claim status, follow up on unpaid claims, and appeal denied claims to ensure timely payment. Patient billing: Calculate patient responsibility, send statements, and handle inquiries. Compliance: Adhere to HIPAA regulations and all payer requirements. Insurance provider enrollment: Execute enrollment processes, set up, and maintain CAQH Provider Profiles. Prior authorizations: Obtain as needed for allied health services. Use and assignment of billing codes; stay current on coding procedures. Balance end-of-day according to clinic policies; track payments from sources like Touchnet, Clover, Zealous, Availity, WayStar, and student accounts. Essential Job Functions Provide written or verbal fee determinations for all clinical services. Establish and monitor accounts payable and receivable for all clients. Handle insurance processes such as benefit inquiries, prior approval, and physician referral requests. Submit insurance claims via standard or electronic methods. Update, monitor, and follow up on all electronic and paper claims. Monitor delays and denials of claims and prior approval requests. Assist with data collection for statistical reports. This role has extensive phone and email contact with Medicaid, Medicare, BCBS of NC, state & local agencies including CDSA. It also manages insurance provider enrollment process and setup. Secondary responsibilities include assisting office staff, students, and clinical faculty with routine and complex office procedures, including electronic health records. Other tasks involve client file reviews and audits, updating clinic materials database, and ordering diagnostic/therapy test materials and forms. Minimum Qualifications Bachelor's degree (or equivalent combination of training and experience) from an accredited institution. Preferred Qualifications Basic office and supervisory skills; ability to produce and evaluate data. Independent work, handling pressure, prioritizing tasks, and remaining focused in a busy environment. Experience with electronic health records, private-pay, third-party, and insurance billing, including claim submissions. Certificate or associate’s degree in medical billing and coding. Knowledge, Skills, & Abilities Knowledge of electronic health records and billing policies across multiple insurance agencies. Ability to oversee all insurance processes: benefit inquiries, prior approvals, physician referrals. Update and monitor electronic and paper claims. Ensure insurance provider enrollment and set up. Work with EHR and oversee implementation of electronic billing process. Knowledge of HIPAA regulations. Employment Details Work Schedule: Monday-Friday, 8:00 am – 5:00 pm. Hours per week: 40 Months per year: 12 Pay commensurate with applicant competencies, budget, equity, and market considerations. #J-18808-Ljbffr