Patient Billing Specialist

Patient Billing Specialist

Company: New England Orthopedic Surgeons (NEOS), a division of Northeast Orthopaedic Alliance (NOA)
Location: 300 Birnie Ave, Springfield MA
Position Type: Full-Time
Schedule: Monday–Friday, 7:30 AM - 4:00 PM or 8:00 AM - 4:30 PM
Department: Billing
FLSA Status: Non-Exempt

Summary

The Patient Billing Specialist is responsible for managing patient billing and accounts receivable activities using the Athena EHR (athenahealth) system. This role ensures accurate and timely claim submission, payment posting, and follow-up to support efficient revenue cycle operations. The position works closely with internal teams, insurance carriers, and patients to resolve billing issues while maintaining compliance with payer guidelines and organizational standards.

Essential Duties & Responsibilities

• Manage assigned payer accounts receivable, ensuring claims over 120 days do not exceed 10% of total A/R

• Submit, monitor, and follow up on insurance claims to resolve unpaid, underpaid, or denied claims

• Verify patient demographics, insurance eligibility, and benefits

• Process claims, payments, adjustments, and post payments from patients and insurance carriers, including EOBs and ERAs

• Identify, research, and resolve billing discrepancies, denials, and underpayments

• Manage Workers’ Compensation accounts when applicable, including payment posting, denial resolution, and communication with claims adjusters

• Communicate professionally with insurance carriers, claims adjusters, and patients to resolve billing inquiries, including billing-related phone calls

• Accurately document all billing activity within Athena EHR

• Collaborate with front desk, clinical, and coding staff to ensure complete and accurate billing

• Maintain compliance with HIPAA, payer requirements, and organizational policies

• Meet established productivity, accuracy, and timeliness standards

• Perform other billing-related duties as assigned

Qualifications

• Strong understanding of medical billing terminology, including CPT, ICD-10, and HCPCS

• Working knowledge of Medicare, Medicaid, and commercial insurance plans

• High attention to detail with strong organizational and multitasking skills

• Ability to analyze billing issues and resolve discrepancies effectively

• Experience with Workers’ Compensation billing preferred

• Prior experience with Athena EHR (athenahealth) billing modules preferred

• Knowledge of HIPAA and healthcare compliance regulations required

Physical Requirements

• Ability to perform sedentary office work, including prolonged sitting

• Frequent use of a computer, keyboard, and mouse

• Ability to view computer screens for extended periods

• Occasional lifting of files or office materials up to 10–15 pounds

Work Environment

• Office-based, fast-paced healthcare environment

• Frequent interaction with patients, insurance companies, and healthcare staff via phone and electronic communication

• Standard business hours with occasional overtime as needed to meet workload demands