Billing Specialist

About Patheous Health

Patheous Health is a leader in the field of dysphagia and swallowing impairment diagnostics. We seek individuals that want to help advance our business and impact healthcare. We take pride in our ability to help our skilled nursing, long term care and rehabilitation clients care for their elderly patients by providing a valuable, timely and care driven service.

Job Summary

The Billing Specialist is responsible for accurately preparing and submitting medical claims, resolving billing discrepancies, posting payments, and ensuring compliance with healthcare regulations and payer requirements. This role plays a vital part in maintaining the financial health of our organization by ensuring timely and accurate reimbursement for services rendered.

Key Responsibilities

· Prepare, review, and submit medical claims to insurance companies, Medicare, Medicaid, and other third-party payers.

· Verify insurance coverage, obtain prior authorizations when required, and ensure all billing documentation is complete and accurate.

· Post payments, adjustments, and denials to patient accounts in the practice management system.

· Investigate and resolve claim rejections or denials, including preparing and submitting appeals.

· Communicate with patients, insurance carriers, and internal teams to resolve billing inquiries and discrepancies.

· Maintain confidentiality of patient information in compliance with HIPAA regulations.

· Stay current with payer requirements, medical billing codes, and compliance guidelines.

· Generate and review aging reports to follow up on unpaid or underpaid claims.

· Assist with month-end reporting and reconciliation as needed.

· Assign tasks and conduct training to other office personnel as required.

· Collaborate with office and clinical personnel to enhance process improvement practices.

· Additional duties may be assigned as needed.

Supervision Received

· Director of Clinical Programs

Supervision Exercised

· No direct reports

Qualifications

Required:

· High school diploma or equivalent; additional coursework in medical billing or healthcare administration preferred.

· 2 years of medical billing experience, preferably in a diagnostic, therapy, or specialty healthcare setting.

· Knowledge of CPT, ICD-10, and HCPCS coding.

· Familiarity with Medicare, Medicaid, and commercial insurance billing requirements.

· Proficiency with practice management software and Microsoft Office Suite.

· Strong attention to detail, problem-solving, and organizational skills.

· Excellent communication skills with the ability to work collaboratively across teams.

Preferred:

· Certification as a Certified Professional Biller (CPB) or Certified Professional Coder (CPC).

· Experience with dysphagia testing, speech therapy, or related medical specialties.

Work Environment & Physical Requirements

· Office-based or hybrid setting.

· Extended periods of computer use and data entry.

· Occasional phone communication with patients, providers, and payers.

Job Type: Full-time

Pay: $22.00 - $25.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $22 - $25