The Billing Specialist I is responsible for performing insurance claim processing, billing, and follow-up to ensure timely and accurate reimbursement. This position serves as the primary contact for insurance companies and other payers, researching and resolving claim issues while maintaining compliance with billing regulations and organizational policies.
Essential duties include:
- Submitting and processing claims accurately and efficiently in accordance with payer requirements and company policies
- Communicating with insurance companies, patients, and other stakeholders to resolve billing inquiries and maintain account status
- Reviewing and reconciling credit balances, reclassifying revenue, and processing adjustments per transaction coding guidelines
- Monitoring and resolving claim denials and rejections, identifying trends, and implementing corrective actions
- Reviewing and correcting claim filing edits based on payer requirements and EHR system alerts
- Maintaining accurate documentation of all billing actions in the practice management system
- Gathering, updating, and communicating billing policy changes and maintaining current reference materials
- Collaborating with management, clinic staff, and coding teams to ensure proper billing and collection procedures
- Assisting patients and insurance representatives with billing-related questions in a professional manner
- Ensuring compliance with HIPAA regulations and maintaining confidentiality of patient financial and medical information
- Performing other duties as assigned
- Maintaining regular and reliable attendance
- Complying with all policies and standards
Requirements & Qualifications
0-2 years of experience in medical billing, insurance claims processing, or revenue cycle management is required.
Knowledge, skills, and abilities:
- 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 such as Athena, Cerner, and Ingenious Med
- Ability to interpret explanation of benefits (EOBs), identify billing discrepancies, and take corrective action
- Excellent communication and interpersonal skills for interacting with patients, providers, and payers
- 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 patient confidentiality
Preferred certifications:
- CPB, Certified Medical Biller, issued by AAPC
- Certified Medical Insurance Specialist (CMIS), issued by PMI
Benefits & Perks
Benefits and perks
- Competitive pay
- Medical, dental, vision, and life insurance coverage
- Generous PTO and extended illness benefits
- 401(k) with company match
- Career development, learning opportunities, and advancement pathways
- Licensure and certification reimbursement for eligible roles
- Student loan support for eligible roles
- Employee rewards and recognition programs
- Additional voluntary benefits such as pet insurance, identity protection, and legal insurance
Location
Alabama, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago