Billing Specialist

POSITION SUMMARY: The Billing Specialist is responsible for preparing, submitting, and following up on all assigned insurance claims to ensure timely reimbursement. This role also assists patients with billing inquiries, payment arrangements, and account resolution, while maintaining compliance with all regulatory and confidentiality requirements.

KEY RESPONSIBILITIES:

• Prepare, submit, and track electronic and manual insurance claims; verify accuracy and correct any errors or rejections.
• Review daily and monthly reports, including aging and past-due accounts, to ensure prompt follow-up.
• Process claims denials and appeals; coordinate with patients, providers, and insurance companies to resolve issues.
• File secondary insurance claims and generate patient statements as needed.
• Document all account activity with clear and concise ledger notes
• Respond to patient phone calls and insurance inquiries in a professional and timely manner.
• Establish payment plans, cost estimates, and payment agreements in accordance with office policies.
• Determine write-offs following established guidelines.
• Post payments when needed.
• Serve as backup for daily electronic claims submission.
• Perform additional duties as assigned.

REQUIRED SKILLS & COMPETENCIES:

• Strong attention to detail and accuracy.
• Ability to interpret and apply insurance billing rules and coding guidelines.
• Commitment to maintaining patient confidentiality
• Proficient computer skills, including 10-key and data entry.
• Ability to work independently and as part of a team.
• Excellent verbal and written communication skills.

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent
• Prior experience in medical billing or insurance claims preferred.

WORK ENVIRONMENT: This position operates in a professional office environment within a medical practice. The role routinely uses standard office equipment such as computers, phones, and copiers.

PHYSICAL DEMANDS: While performing the duties of this job, the employee is regularly required to talk, hear, and sit for prolonged periods. The employee may occasionally be required to stand, walk, and lift up to 20 pounds.