Billing Assistant

Description

Job Purpose: To ensure all therapy claims are accurate, compliant, and submitted

within timely filing limits. This role protects clean claim flow, prevents avoidable denials,

and maintains the integrity of patient billing through precise review, proactive

communication, and strict adherence to payer and regulatory requirements.

Claim Review & Submission

• Monitor the Reviewing folder daily and ensure all claims are addressed before the end of day.
• Review newly generated claims for completeness, accuracy, and payer compliance.
• Verify patient demographics, insurance details, subscriber information, and payer setup.
• Confirm authorization status, visit limits, referral requirements, and payer-specific rules prior to submission.
• Correct claim errors related to coding, modifiers, demographics, insurance configuration, or provider setup.
• Submit all claims within timely filing limits to prevent avoidable delays or missed deadlines.
• Coordinate with front desk staff when demographic or insurance corrections are required.
• Maintain clean claim flow by proactively identifying issues and preventing avoidable denials.
• Communicate payer-specific trends, recurring issues, or workflow concerns to the Finance Manager.
  
  

Compliance & Privacy

• Adhere to HIPAA regulations when handling patient billing information and PHI.
• Stay updated on payer policies, reimbursement changes, and CPT/ICD coding updates.
• Submit claims only for accurate services rendered and supported by proper documentation.
• Avoid submitting inaccurate, incomplete, or unsupported billing information.
• Follow all applicable coding, billing, authorization, credentialing, and documentation requirements.
• Maintain confidentiality and security of PHI and sensitive patient information at all times.
  
  

Communication

• Communicate promptly and professionally with therapists, administrative staff, and leadership regarding claim discrepancies or missing information.
• Clearly communicate documentation needs or required corrections to the appropriate team member.
• Maintain organized documentation of claim-related communication, corrections, and actions taken.
• Notify leadership of recurring claim issues, payer changes, or EMR workflow concerns.
• Maintain professional, consistent communication when clarifying documentation or payer requirements.
  
  

Requirements

• Attention to Detail: Ability to review information carefully and catch small errors that impact claim accuracy
• Basic Computer Literacy: Comfortable navigating EMR systems, payer portals, and standard office software.
• Organizational Skills: Able to manage daily claim queues, prioritize tasks, and maintain clean workflow.
• Coachability & Willingness to Learn: Open to feedback, training, and developing competency in billing processes.
• Professional Communication: Able to communicate clearly and respectfully with staff when clarifying information or requesting corrections.
• Problem-Solving Mindset: Able to identify issues, ask questions, and seek guidance when something appears incorrect.
• Confidentiality & Integrity: Understands the importance of protecting patient information and submitting only accurate claims.
• Reliability & Consistency: Shows up ready to work, follows processes, and completes tasks within expected timelines.