Billing Specialist

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• Submits and processes claims accurately and efficiently, ensuring compliance with payer requirements and company policies.
• Communicates with insurance companies, patients, and other stakeholders to resolve billing inquiries and maintain account status.
• Reviews and reconciles credit balances, reclassifies revenue, and processes adjustments per transaction coding guidelines.
• Monitors and resolves claim denials and rejections, identifying trends and implementing corrective actions.
• Reviews and corrects claim filing edits based on payer requirements and electronic health record (EHR) system alerts.
• Maintains accurate documentation of all billing actions in the practice management system.
• Gathers, updates, and communicates billing policy changes, ensuring accessibility of up-to-date reference materials.
• Collaborates with management, clinic staff, and coding teams to ensure proper billing and collection procedures.
• Assists patients and insurance representatives with billing-related questions while maintaining professionalism.
• Ensures compliance with HIPAA regulations and maintains confidentiality of patient financial and medical information.
• Performs other duties as assigned.

• Knowledge of medical billing processes, insurance claim procedures, and payer policies.
• Strong understanding of healthcare revenue cycle operations and reimbursement methodologies.
• Proficiency in electronic health records (EHR) and practice management systems (e.g., Athena, Cerner, Ingenious Med).
• Ability to interpret explanation of benefits (EOBs), identify billing discrepancies, and take corrective action.
• Excellent communication and interpersonal skills to interact with patients, providers, and payers professionally.
• Strong analytical and problem-solving abilities to research and resolve billing issues.
• Attention to detail and ability to manage multiple tasks while meeting deadlines.
• Working knowledge of HIPAA regulations and the importance of maintaining patient confidentiality.

• health insurance
• 401(k)
• licensure/certification reimbursement
• tuition reimbursement
• student loan assistance

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