BILLING SPECIALIST I

Responsibilities

• Maintains exemplary customer service skills with patients, vendors and co-workers.
• Completes patient check-out following clinical visits.
• Collects and posts copayments, coinsurance, deductibles, and self-pay balances.
• Reviews charges, appropriate diagnosis, and verifies services rendered prior to billing.
• Confirms and updates patient demographics and insurance information.
• Generates patient statements, receipts, and follow-up instructions.
• Educates patients on billing questions, balances, and payment options.
• Applies payments and adjustments accurately in the practice management system.
• Identifies and escalates billing discrepancies or missing documentation.
• Collaborates with clinical and billing teams to ensure clean claim submission.
• Maintains balanced day sheets and receipts; reviews and submits clinic batches in a timely manner.
• Interacts daily with medical or support staff to ensure proper education and updates are given to assist billing in clean claim submission.
• Proofs and corrects claims prior to submission.
• Processes insurance authorizations as needed.
• May assist in training other employees on billing-related duties.
• Performs other reasonably related duties as assigned.

Qualifications

• Education: High school diploma or equivalent. Medical coding training or equivalent.
• Experience: One year of medical front desk or medical billing experience is preferred. An equivalent combination of education and experience that provides the required knowledge and abilities will be considered.
• Certification/License: None required.
• Knowledge: Medical terminology, CPT and ICD-10 coding, use of standard software such as Windows, Word, and Excel.
• Ability: To speak English and Spanish fluently, learn billing requirements of all SBNC payers, and acquire an understanding of the electronic billing process, follow verbal and written instructions, communicate effectively, verbally and in writing, use standard office equipment, including computers, copy machine, fax machine, and postage meter.
• Physical Demands: May be required to lift objects weighing up to 25 pounds. Sitting in a normal seated position for extended periods of time. Reaching by extending hand(s) or arm(s) in any direction. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s).