Front End/Prebill Edit Specialist

Job Description

Job Description

Front End / Prebill Edit Specialist

Full-Time | Monday–Friday | 8:00 AM – 5:00 PM
Pay: $18–$20/hour DOE

We are currently seeking a detail-oriented and dependable Front End / Prebill Edit Specialist to join a growing healthcare billing team. This position is ideal for someone with strong insurance verification, billing, and patient account experience who thrives in a fast-paced environment and enjoys problem-solving and accuracy-focused work.

The ideal candidate will have experience working within a physician office, hospital, laboratory, or pathology billing environment and possess excellent communication and organizational skills.

Position Summary

The Front End / Prebill Edit Specialist will be responsible for reviewing and correcting billing edits, verifying patient demographic and insurance information, maintaining accurate claim documentation, and supporting patient accounts receivable functions. This role works closely with billing staff and management to ensure clean claims submission and efficient revenue cycle processes.

Essential Duties & Responsibilities

Data Verification

• Cross-check and perform data entry of patient demographics, insurance information, and eligibility verification
• Confirm correct ordering client, ordering physician, and date of service information
• Maintain accurate claim notes within the billing system to ensure proper audit trail documentation
• Follow HIPAA guidelines and confidentiality policies regarding patient information

Collaboration & Workflow Support

• Collaborate with staff to correct insurance and demographic discrepancies
• Escalate recurring billing edit trends or workflow concerns to billing management
• Assist with improving billing accuracy and workflow efficiency

Patient Accounts Receivable

• Handle patient phone calls regarding balances, EOB explanations, and patient responsibility
• Collect patient balances professionally and courteously
• Process returned mail and update patient addresses and demographics as needed
• Perform additional patient account follow-up and collection responsibilities as assigned

Qualifications

• Knowledge of eligibility verification tools, payer portals, and insurance eligibility systems required
• Familiarity with billing systems and clearinghouse edits preferred
• Prior experience in healthcare billing, medical office, hospital, laboratory, or pathology billing strongly preferred
• Strong attention to detail and problem-solving abilities
• Ability to work independently while meeting productivity and accuracy deadlines
• Professional communication and customer service skills required
• Proficiency with computer systems and data entry required

Schedule & Compensation

• Full-Time
• Monday through Friday
• 8:00 AM – 5:00 PM
• $18–$20/hour DOE

This is an excellent opportunity for someone looking to continue building a long-term career within healthcare revenue cycle and billing operations while working with a collaborative and professional team environment.

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