Join a dedicated healthcare team in the heart of the Midwest region, where your role as a Billing Specialist I is vital to the financial health of the organization. This full-time, day shift position involves managing insurance claims, patient billing inquiries, and ensuring accurate data entry to support smooth revenue cycles.

General Summary

As a Billing Specialist I, you will be responsible for collecting and entering claims data, posting insurance payments, submitting claims, and addressing patient questions regarding their accounts. You will report directly to the Billing Supervisor and play a key role in maintaining accurate billing processes.

Essential Duties and Responsibilities

• Enter necessary information for insurance claims, including patient and insurance details, ensuring completeness and accuracy.
• Submit insurance claims electronically or via paper forms such as UB04 and CMS-1500.
• Respond to patient inquiries about copays, deductibles, write-offs, and other billing concerns, resolving complaints or explaining coverage limitations.
• Follow up with insurance companies on unpaid or rejected claims, resolve issues, and resubmit as needed.
• Prepare appeal letters for denied claims, gathering all required documentation.
• Adhere to HIPAA guidelines when handling patient information.
• Perform soft collections by contacting patients regarding past due accounts through phone or mail.
• Understand managed care authorizations and coverage limits, verifying patient benefits eligibility.
• Prepare and submit secondary claims after primary insurer processing.

Education

High School Diploma or GED is required.

Experience

Previous medical billing experience is highly preferred, along with familiarity with billing software and electronic data submission.

Certification/License

Not specified.

Mental/Physical Requirements

Ability to communicate detailed information clearly, maintain concentration during repetitive tasks, and perform physical activities such as standing, walking, sitting, reaching, and occasionally lifting items up to 10 pounds.

Working Conditions

Standard office environment with occasional exposure to noise, fumes, chemicals, hazards, or diseases.