Billing Specialist

About the role

We are seeking a highly motivated Billing Specialist to support the revenue cycle at HHM Health. This position plays a critical role in maximizing revenue while maintaining compliance with various regulations.

Responsibilities

• Prepare, review, edit, and submit accurate electronic and paper claims to Medicare, Medicaid, commercial insurance, and other third-party payers in a timely manner.
• Enter facility charges, verify patient demographics, insurance eligibility, and encounter information to ensure accurate billing and reimbursement.
• Interpret Explanation of Benefits, update patient insurance information, and maintain accurate patient billing records and account documentation.
• Process patient statements, post insurance and patient payments, adjustments, refunds, contractual allowances, write-offs, and reconcile daily payment batches.
• Monitor claim status, resolve claim edits, denials, rejections, unpaid claims, and payment discrepancies, and submit corrected claims and appeals as needed.
• Manage accounts receivable by monitoring aging reports, following up with insurance carriers, and coordinating the resolution of outstanding claims and billing issues.
• Apply knowledge of FQHC billing requirements, Medicare and Medicaid reimbursement, sliding fee discount programs, UDS reporting, and grant-funded billing initiatives.
• Ensure compliance with HRSA, CMS, HIPAA, Medicare, Medicaid, and organizational billing policies, procedures, and regulatory requirements.
• Communicate with patients regarding billing inquiries, account balances, payment arrangements, financial responsibilities, and provide exceptional customer service.
• Collaborate with providers, coders, medical assistants, front office staff, and leadership to resolve billing issues, improve documentation, and optimize revenue cycle performance.
• Maintain accurate records, logs, journals, and documentation within the electronic health record (EHR) and practice management systems while supporting audits, reporting, and quality improvement initiatives.
• Analyze payer trends, recommend process improvements to reduce denials and maximize reimbursement, and perform other revenue cycle and billing responsibilities as assigned.

Requirements

• A high school diploma or equivalent required; an associate's degree in Medical Billing, Revenue Cycle, Healthcare Administration, or a related field preferred, or an equivalent combination of education and experience.
• Minimum of two (2) years of medical billing or revenue cycle experience, preferably in an FQHC, community health center, physician practice, or ambulatory care setting.
• Strong experience with Medicare, Medicaid, commercial insurance, managed care billing, and healthcare reimbursement processes.
• Working knowledge of FQHC billing regulations, sliding fee discount programs, UDS reporting, and HRSA/CMS requirements.
• Knowledge of ICD-10-CM, CPT, HCPCS coding principles (and ICD-9 familiarity where applicable), along with medical, dental, and vision billing practices.
• Proficiency with electronic health records (eClinicalWorks or similar), practice management systems, Microsoft Office Suite, billing software, clearinghouses, and payer portals.
• Strong analytical, organizational, problem-solving, and time management skills with the ability to manage multiple priorities in a fast-paced environment.
• Excellent written, verbal, interpersonal, and customer service skills with the ability to work independently and collaborate effectively with multidisciplinary teams.
• Demonstrated commitment to service excellence, patient-centered care, and providing compassionate service to culturally diverse and underserved populations while maintaining regulatory compliance and attention to detail.

Qualifications

• High school diploma or equivalent required.
• Associate's degree in Medical Billing, Revenue Cycle, Healthcare Administration, or a related field preferred.
• Two (2) years of medical billing or revenue cycle experience, preferably in an FQHC, community health center, physician practice, or ambulatory care setting.
• Strong experience with Medicare, Medicaid, commercial insurance, managed care billing, and healthcare reimbursement processes.
• Working knowledge of FQHC billing regulations, sliding fee discount programs, UDS reporting, and HRSA/CMS requirements.
• Knowledge of ICD-10-CM, CPT, HCPCS coding principles (and ICD-9 familiarity where applicable), along with medical, dental, and vision billing practices.
• Proficiency with electronic health records (eClinicalWorks or similar), practice management systems, Microsoft Office Suite, billing software, clearinghouses, and payer portals.
• Strong analytical, organizational, problem-solving, and time management skills with the ability to manage multiple priorities in a fast-paced environment.
• Excellent written, verbal, interpersonal, and customer service skills with the ability to work independently and collaborate effectively with multidisciplinary teams.
• Demonstrated commitment to service excellence, patient-centered care, and providing compassionate service to culturally diverse and underserved populations while maintaining regulatory compliance and attention to detail.

Skills

• Strong analytical, organizational, problem-solving, and time management skills.
• Excellent written, verbal, interpersonal, and customer service skills.
• Proficiency with electronic health records (eClinicalWorks or similar), practice management systems, Microsoft Office Suite, billing software, clearinghouses, and payer portals.
• Knowledge of ICD-10-CM, CPT, HCPCS coding principles (and ICD-9 familiarity where applicable).
• Strong understanding of FQHC billing requirements, Medicare and Medicaid reimbursement, sliding fee discount programs, UDS reporting, and HRSA/CMS requirements.
• Experience with managing accounts receivable, resolving claim issues, and optimizing revenue cycle performance.
• Ability to communicate effectively with patients, providers, and other team members.
• Commitment to service excellence, patient-centered care, and providing compassionate service to culturally diverse and underserved populations.

Benefits

• Free vision, dental, and life insurance.
• Competitive medical premiums.
• 403(b) retirement savings plan with dollar-for-dollar matching up to 3% and match 50% of the next 2% (contribute 5% to get 4% matched).
• 100% vested upon enrollment.
• Generous time off plan for full-time employees (Health and wellness + Paid time +Volunteer Days).
• Paid Holidays.
• Accidental Death & Dismemberments (ADD) plan.
• Short-term & Long-term Disability.
• Employee Assistance Programs (EAP).
• HHM CARES Fund (employee emergency relief fund).

Pay

Compensation is commensurate with experience.

Schedule

This position is based on-site (5 days a week) at 4550 Gus Thomasson Rd, Ste. 40, Mesquite, TX 75150.