Billing Specialist (On-Site)

We are seeking a detail-oriented and dependable Billing Specialist to join our team. This entry-level position supports the day-to-day billing operations by processing claims accurately and efficiently, maintaining billing information, and helping ensure claims are submitted in accordance with insurance payer requirements.

Duties & Responsibilities

1. Claims Processing:
   • Process 50–90+ claims daily with a focus on accuracy.
   • Review and verify billing codes (HCPCS), diagnostic information, and span dates for compliance.
   • Submit claims to insurance agencies, Medicare/Medicaid, and other payers.
2. Insurance Verification:
   • Conduct eligibility checks using systems like Brightree and Availity.
   • Ensure patient insurance information is up to date and communicate coverage details (deductibles, coinsurance) to relevant teams.
3. Dispute Resolution:
   • Handle disputes, appeals, and follow-up tasks for denied or pending claims.
   • Address phone inquiries related to billing issues.
4. Data Management:
   • Maintain accurate records of claims and patient billing information.
   • Update patient accounts and billing systems as needed.
5. Collaboration:
   • Work closely with the Customer Experience Team and management to resolve billing discrepancies.
   • Support office operations as needed (e.g., shipping confirmations, Sales Order reviews).

Qualifications

• Education: High School Diploma
• Experience: 0–2 years in a healthcare office or administrative setting. 
• Technical Skills: Proficiency in Microsoft Office and data entry.
• Soft Skills: Strong communication, organizational skills, and teamwork.
• Preferred Knowledge: Familiarity with Brightree, Availity, or similar billing software.
• Claim Form: Knowledge of CMS 1500