A Billing Specialist performs administrative work at financial institutions and banks that handle bills, receipts, and invoices. Manages the status of client accounts and tracks financial records, charges, and receipts of the accounts.
We are seeking a detail-oriented and experienced Insurance Denial and Billing Specialist to join our team. In this dual-role position, you will be responsible for both managing and appealing denied insurance claims and overseeing the billing process to ensure timely and accurate payments. You will play a critical role in resolving discrepancies, reviewing claim denials, and facilitating seamless billing and payment operations for our organization or clients.
This position requires a strong understanding of insurance policies, billing processes, and the ability to communicate effectively with insurance providers and healthcare professionals.
Key Responsibilities :
Insurance Denial Management :
Review and analyze denied insurance claims to determine the cause of the denial. Work with insurance providers, healthcare professionals, or clients to gather additional information or clarify issues. Appeal denied claims with proper documentation and supporting evidence to ensure successful resolution. Maintain accurate records of all denied claims, communications, and resolutions. Track and follow up on claims to ensure timely resolution and payment.
Billing and Payment :
Prepare and submit accurate insurance claims to various insurance providers. Verify the accuracy of billing codes, insurance information, and claim details before submission. Resolve any billing discrepancies by working closely with clients, insurance providers, or internal departments. Assist with financial reporting related to insurance billing and claims.
Cross-functional Collaboration :
Collaborate with billing, coding, and customer service teams to ensure efficient and accurate billing and claims processing. Provide guidance and support to team members regarding billing and insurance denial procedures.
Other Responsibilities :
Stay current on insurance policies, billing regulations, and industry trends. Participate in ongoing training and professional development programs. Meet daily/weekly/monthly targets for both claim resolution and billing submissions.
Qualifications :
High school diploma or equivalent (required); Associate's or Bachelor's degree in Business Administration, Healthcare Administration, or a related field (preferred). 2+ years of experience in insurance claims, billing, or denials management (medical or general insurance experience preferred). Strong understanding of insurance billing procedures, codes (CPT, ICD, etc.), and insurance policies. Experience with claims software or billing systems (Epic, Waystar and ADS). Strong attention to detail and the ability to manage multiple priorities efficiently. Excellent written and verbal communication skills. Proficient in Microsoft Office Suite (Excel, Word, etc.). Ability to work independently and as part of a collaborative team. Strong problem-solving and analytical skills.
Pay:
$18.00 - $25.00 per hour
Benefits:
401(k) Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance
Education:
Associate (Preferred)
Experience:
insurance claims, billing, or denials management: 2 years (Preferred) Ability to
