Senior Clinical Billing Specialist
New
Based in the United StatesFull-TimeSenior
Salary18.99 USD per hour
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Job Details
- Experience
- 5+ years with HS diploma/GED, 3+ years with Associate's degree, or 1+ year with Bachelor's degree in healthcare revenue cycle or bookkeeping
- Required Skills
- Bookkeeping
Requirements
- High school diploma or GED with 5+ years of healthcare revenue cycle or bookkeeping experience, Associate’s degree with 3+ years, or Bachelor’s degree with 1+ year.
- Strong understanding of medical billing processes, insurance claims, and revenue cycle operations.
- Experience with healthcare billing systems (EPIC preferred) and claims management tools.
- Knowledge of insurance policies, denial management, and appeals processes.
- Strong analytical and problem-solving skills with attention to detail and accuracy.
- Excellent verbal and written communication skills.
- Basic mathematical skills and ability to manage financial data accurately.
- Strong organizational skills with the ability to manage multiple priorities.
- Solid understanding of HIPAA compliance and patient confidentiality requirements.
Responsibilities
- Investigate and resolve complex physician and hospital account balances, identifying causes of non-payment and initiating claim corrections or resubmissions.
- Analyze denied claims, determine root causes, and prepare appeals within required timelines to prevent write-offs.
- Develop and submit appeal letters, gather supporting documentation, and ensure proper follow-up with payers.
- Perform cash reconciliation and ensure accuracy of financial and billing records.
- Assist patients with billing inquiries, insurance questions, and account clarifications via phone and electronic communication.
- Update patient and insurance information, verify coverage details, and ensure accurate claim submission and resubmission.
- Post payments, manage payment plans, and complete end-of-day processing activities.
- Support collections processes and coordination with external agencies to ensure continuity of revenue recovery.
- Interpret contract documents and apply billing guidelines accurately in account resolution.
- Ensure compliance with HIPAA regulations, confidentiality standards, and organizational billing policies.
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