Billing and Collections Specialist

Business Office – Billing & Collections Specialist

We are seeking a detail-oriented Business Office – Billing & Collections Specialist to support revenue cycle operations within a healthcare environment. This position is responsible for ensuring accurate billing, maximizing reimbursement, managing claims processing, resolving denials, and maintaining timely collections across multiple payer types. The ideal candidate will have experience in healthcare business office functions and a strong understanding of patient financial processes.

Key Responsibilities

• Process and submit accurate claims while ensuring billing and coding compliance.
• Review claims for authorization, eligibility, clean claim submission, and reimbursement accuracy.
• Monitor claim status through clearinghouses and payer portals and resolve claim edits or holds.
• Interpret insurance benefits and payer contracts to support reimbursement and collections efforts.
• Investigate and resolve denials, appeals, underpayments, and billing discrepancies.
• Perform accounts receivable follow-up and support month-end billing activities.
• Communicate with patients, providers, and internal departments regarding financial and billing matters.
• Maintain documentation within patient accounting systems and electronic health records.
• Generate reports and support ongoing revenue cycle performance initiatives.
• Deliver excellent customer service while maintaining confidentiality and HIPAA compliance.

Qualifications

• High School Diploma or equivalent required.
• Minimum 1 year of healthcare business office, medical billing, collections, or revenue cycle experience preferred.
• Knowledge of insurance verification, claims processing, reimbursement, and denial management.
• Experience using patient accounting systems, Microsoft Office, and Excel.
• Strong communication, organization, and problem-solving skills.
• Ability to work independently while collaborating in a team environment.
• Knowledge of medical terminology preferred.

Preferred Experience

• Healthcare billing and collections
• Accounts receivable follow-up
• Insurance claim processing
• Revenue cycle management
• Patient financial services
• Appeals and denial resolution

This position may support additional business office functions as operational needs evolve and requires flexibility in a fast-paced healthcare setting.