Billing Specialist

Job Description

Job Description

| Department: | RCM | Supervises: | Sub-Department: | Corporate Support Center |
Reports To: | Billing Specialist | Date Completed: | 06/06/2025

General Position Description:
Ensure claim accuracy and high-quality customer service through review, correction, and resubmission of rejected and delinquent claims within timely filing limits.

Core Responsibilities:

• Review all assigned Practice Management claim errors, determine the appropriate action, correct and file all claims with error status
• Review all assigned Clearinghouse claim errors, determine the appropriate action, correct and file all claims with error status and note actions in patients chart
• Review all assigned insurance payor rejections, determine the appropriate action, correct and re-file all rejected claims Review and maintain the Clearinghouse workgroup list, ensure the resubmission process is complete
• Ensure that all claims within assigned receivables meet timely filing requirements
• Assist management in identifying trends in rejection results with various insurance carriers
• Maintain current knowledge of assigned insurance carriers rules and regulations both federal and commercial
• Ensure that month-end goals are met in a timely manner
• Work with clinic supervisors and staff to improve the capture and accuracy of demographic information as well as other information critical to claim processing and reimbursement
• Observe safety and security procedures; promote a safe and pleasant work environment
• Regular attendance to ensure efficient operations
• Assist in questions from other departments concerning rejections

Other duties and responsibilities:

• Other duties and responsibilities as assigned.

Qualifications:

• High school graduate or equivalent.
• Proven ability to work in a team environment.
• Articulate communication skills and excellent customer service skills.
• Computer knowledge, e.g., Microsoft Office. Accuracy and detail orientation with high level of productivity.
• Familiarity with ICD-10, and CPT coding, as well as experience reviewing and understanding insurance EOBs is preferred.

Physical Demands/Work Conditions:

• Office environment. Sitting and keyboarding for extended periods of time.
• High attention to detail and ability to focus. Moderate noise level.