Billing Specialist

Position Summary:

The Billing Specialist is responsible for preparing and entering billing information for patient accounts. The position requires experience in a medical office setting and knowledge of coding and reimbursement processes.

Key Responsibilities:

Explain billing policies and procedures to patients in a clear and professional manner.

Review route slips to ensure all required patient, provider, procedure, and diagnostic information is accurate.

Handle all phases of billing based on requirements.

Perform eligibility reviews for sliding scale adjustments.

Submit, finalize, and follow up on insurance claims and re-billing when necessary.

Post payments, process RA/EOBs, and reconcile suspended or denied claims.

Generate reports for the finance team.

Bill patients or secondary insurers for unpaid balances.

Manage patient accounts including adjustments, payment plans, and collections.

Respond to billing inquiries from patients and staff.

Ensure compliance with HIPAA, OSHA, CLIA, and Joint Commission standards.

Maintain professionalism and confidentiality at all times.

Assist other departments and support satellite facilities as needed.

Perform other related duties as assigned.

Qualifications:

Associate’s degree or equivalent education and experience.

Minimum 1 year of billing experience in a healthcare setting.

ICD-9/ICD-10 coding and Medicare billing experience required.

Knowledge of CPT/HCPCS coding and AMA/CMS guidelines.

Strong communication, customer service, and organizational skills.

Must have valid California driver’s license, reliable transportation, and auto insurance.