Billing Specialist

Key Responsibilities

• Prepare, review, and submit medical claims to insurance companies (electronic and paper)
• Verify patient insurance coverage, eligibility, and benefits
• Follow up on unpaid or denied claims and resolve billing issues promptly
• Post payments from insurance companies and patients accurately
• Generate and send patient statements and assist with payment plans when needed
• Communicate with patients/parents regarding billing questions in a professional and compassionate manner
• Maintain uptodate knowledge of coding (CPT, ICD10) and billing regulations
• Ensure compliance with HIPAA and all healthcare billing standards
• Reconcile accounts and maintain accurate financial records
• Collaborate with clinical and administrative staff to ensure proper documentation for billing
• Greet patients and families in a friendly and professional manner
• Answer phone calls, schedule appointments, and manage patient inquiries
• Check patients in and out, ensuring all demographic and insurance information is accurate
• Collect copayments, balances, and provide receipts
• Maintain patient records and update information in the electronic health record (EHR) system
• Absorb and manage both administrative and billing responsibilities efficiently

Qualifications

• A high school diploma or equivalent required; an associate degree in healthcare administration or related field preferred
• 13 years of medical billing experience, preferably in pediatrics or a family practice setting
• Knowledge of medical terminology, CPT, ICD10, and insurance processes
• Familiarity with front desk or medical receptionist duties
• Experience with electronic health records (EHR) and billing software
• Strong attention to detail and organizational skills
• Excellent communication and customer service skills
• Ability to multitask in a fast-paced environment
• Ability to handle sensitive information with confidentiality

Preferred Skills

• Experience working with pediatric insurance plans (e.g., Medicaid, CHIP)
• Strong interpersonal skills with a patient-focused approach
• Problemsolving mindset with strong follow-up skills