Find & Apply For Billing Clerk / Specialist Jobs in O'Fallon, Illinois

Insurance Billing Specialist Position Summary The Insurance Billing Specialist is responsible for managing the insurance billing and accounts receivable process to ensure timely and accurate reimbursement for healthcare services. This role works closely with insurance carriers, patients, providers, and internal departments to verify insurance coverage, submit and follow up on claims, resolve denials, process payments, and maintain compliance with HIPAA regulations. The ideal candidate is detail-oriented, knowledgeable in healthcare revenue cycle management, and committed to delivering excellent customer service. Key Responsibilities

• Prepare, submit, and monitor electronic and paper insurance claims to ensure timely reimbursement.
• Investigate, resolve, and appeal denied or underpaid claims by reviewing payer guidelines and supporting documentation.
• Research Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and payer correspondence to identify payment discrepancies.
• Follow up with insurance companies regarding unpaid, denied, or pending claims to maximize reimbursement.
• Maintain accurate patient account documentation and billing records within the electronic health record (EHR) and practice management system.
• Communicate professionally with insurance representatives, patients, and clinical staff to resolve billing questions and account issues.
• Educate patients regarding insurance benefits, billing statements, payment responsibilities, and available payment options.
• Ensure compliance with HIPAA regulations and all federal, state, and payer-specific billing requirements.
• Utilize payer websites and online portals to verify benefits, review claim status, obtain policy guidelines, and resolve billing issues.
• Perform additional billing and revenue cycle duties as assigned.

Qualifications Experience:

Minimum of 2-5 years of experience in medical billing, insurance billing, accounts receivable, collections, or healthcare revenue cycle management. Skills

• Strong understanding of insurance verification, benefits interpretation, and patient financial responsibility calculations.
• Experience working insurance claim denials, appeals, and payment follow-up.
• Knowledge of commercial insurance, Medicare, Medicaid, and managed care payer guidelines.
• Proficiency using payer websites and online portals for eligibility verification and claim research.
• Experience with EHR and practice management/billing software.
• Intermediate Microsoft Excel and Microsoft Office skills.
• Strong verbal and written communication with proven customer service and de-escalation abilities.
• Ability to manage multiple priorities while maintaining accuracy and meeting deadlines.
• Thorough understanding of HIPAA privacy and security requirements. Education
• High school diploma or equivalent required.
• Associate's or Bachelor's degree in Business, Healthcare Administration, Medical Office Administration, or a related field preferred. Preferred Qualifications
• Experience with electronic claim submission and payment posting.
• Knowledge of healthcare revenue cycle management and insurance reimbursement processes.
• Experience with account reconciliation and collections.
• Professional, compassionate, and patient-focused communication skills.

Pay:

$50,000.00 - $60,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Flexible spending account Health insurance Life insurance Paid time off Vision insurance

Work Location:

In person