Billing Specialist

The Insurance Billing Specialist is responsible for managing and processing insurance claims, ensuring accurate billing, timely reimbursement, and compliance with payer requirements. This role serves as a key link between patients, providers, and insurance companies to resolve billing issues and minimize claim denials. Key Responsibilities Submit and follow up on insurance claims (commercial, Medicare, Medicaid, etc.) Verify patient insurance eligibility and benefits Review coding (CPT, ICD-10, HCPCS) for accuracy and compliance Identify, correct, and resubmit denied or rejected claims Post insurance payments and adjustments accurately Investigate underpayments and discrepancies Communicate with insurance carriers to resolve claim issues Maintain detailed billing records and documentation Ensure compliance with HIPAA and payer regulations Collaborate with front office, coding, and clinical staff to resolve billing errors Required Skills & Qualifications High school diploma or equivalent (Associate’s degree preferred) 1–3 years of insurance billing or medical billing experience Strong knowledge of insurance plans, billing procedures, and claim forms Familiarity with CPT, ICD-10, and HCPCS codes Experience with EHR/PM systems (e.g., Epic, Cerner, Athena, eClinicalWorks) Strong attention to detail and analytical skills Excellent communication and problem-solving abilities Preferred Qualifications Certification such as CPB, CPC, or CCS Experience in a healthcare, hospital, or medical practice setting Knowledge of Medicare, Medicaid, and managed care guideline