Job Description

Position Summary:

The Billing Specialist is responsible for preparing and entering billing information for patient accounts. The position requires experience in a medical office setting and knowledge of coding and reimbursement processes.

Key Responsibilities:

• Explain billing policies and procedures to patients in a clear and professional manner.
• Review route slips to ensure all required patient, provider, procedure, and diagnostic information is accurate.
• Handle all phases of billing based on requirements.
• Perform eligibility reviews for sliding scale adjustments.
• Submit, finalize, and follow up on insurance claims and re-billing when necessary.
• Post payments, process RA/EOBs, and reconcile suspended or denied claims.
• Generate reports for the finance team.
• Bill patients or secondary insurers for unpaid balances.
• Manage patient accounts including adjustments, payment plans, and collections.
• Respond to billing inquiries from patients and staff.
• Ensure compliance with HIPAA, OSHA, CLIA, and Joint Commission standards.
• Maintain professionalism and confidentiality at all times.
• Assist other departments and support satellite facilities as needed.
• Perform other related duties as assigned.

Qualifications:

• Associate’s degree or equivalent education and experience.
• Minimum 1 year of billing experience in a healthcare setting.
• ICD-9/ICD-10 coding and Medicare billing experience required.
• Knowledge of CPT/HCPCS coding and AMA/CMS guidelines.
• Strong communication, customer service, and organizational skills.
• Must have valid California driver’s license, reliable transportation, and auto insurance.

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