Billing and Accounts Receivables Specialist

Responsibilities

• Obtain prior authorizations for office visits and physician-administered medications
• Work outstanding insurance balances and resolve unpaid claims
• Research, analyze, and follow up on open claims and denials
• Submit appeals and check claim status
• Confirm payments match fee schedules and communicate with insurance companies
• Post payments from insurance carriers, patients, and funding companies
• Verify insurance eligibility and benefits
• Explain patient benefits clearly and professionally
• Calculate patient balances and contact patients by phone
• Review schedules prior to date of service
• Approve scheduled and same-day injections after confirming authorizations
• Support patient assistance program enrollment and education
• Maintain strong communication with physicians, patients, and coworkers
• Use ICD-10 and CPT coding knowledge
• Read and interpret Explanation of Benefits (EOBs)

Qualifications

• High school diploma or equivalent
• Minimum 1 year of billing experience
• Minimum 6 months of accounts receivable experience
• Strong understanding of private insurance rules and regulations
• Excellent organizational skills and attention to detail
• Computer literacy with medical A/R systems and web-based tools
• Ability to work well under pressure and manage interruptions
• Strong customer service and communication skills
• Excel skills, including formulas, pivot tables, and data analysis, are a plus

Benefits

• Health insurance with HSA
• Vision insurance
• Dental insurance
• EAP
• Life insurance
• 401(k) matching
• Profit sharing
• PTO
• Paid holidays