Medical Billing Specialist

Position Overview: Describes the overall purpose of the position or why the position exists

The billing specialist is responsible for all billing activities, including posting charges, payments, and adjustments to patient accounts, to ensure the timely collection of amounts due from patients and/or insurance carriers. This position serves as a liaison between the organization and patients and insurance carriers for billing related issues or inquiries.

Essential Duties and Responsibilities: The following description is a general representation of the essential duties and responsibilities of the position.

• Submit claims to insurance carriers to ensure prompt processing and payment. Follow up on unpaid or outstanding claims to resolve billing issues, including through a review of work queues assigned by the Revenue Cycle Manager.
• Post charges, payments, and adjustments in a timely and accurate manner. Identify accounts that may require refunds.
• Review accounts for potential assignment to collection agencies and make recommendations to the Revenue Cycle Manager.
• Respond to and resolve billing related questions or concerns from patients.
• Maintain confidentiality of patient and financial information at all times.
• Participate in ongoing educational and training activities.
• Other duties as assigned.

The requirements listed below are representative of the knowledge, skills, abilities, experience, and education an individual must possess to be able to perform the essential duties and responsibilities successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential duties and responsibilities.

Education, Licensure, Experience:

• High School Diploma or equivalent required.
• Minimum of 1 year in Medical or Dental billing role required.

Knowledge and Skills:

• Knowledgeable of Governmental (Medicare/Medicaid) and healthcare billing regulations, processes, and reporting requirements.
• Able to work independently with minimal supervision, demonstrating flexibility, reliability, and consistency.
• Strong analytical, organizational, and time management skills, with the ability to learn quickly. Strong mathematical skills.
• Proficient in the use of Billing Software, Microsoft Office Suite, and EPIC EMR/EHR.
• Able to establish and maintain effective working relationships with staff, patients, and external organizations.
• Ability to speak a language other than English fluently preferred.

Essential Physical Demands and Working Environment:

• Able to sit, stand, and stoop for extended periods of time.
• Occasional lifting of up to 25 lbs.
• Able to communicate effectively, both verbally and in writing, including through the use of electronic communication devices.
• Able to travel locally among Community Health Center locations for meetings required.

The physical demands and work environment described above represent those that an employee must meet to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.