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Billing Specialist

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Job Description - Billing Specialist



| Department: | RCM | Supervises: | Sub-Department: | Corporate Support Center |
Reports To: | Billing Specialist | Date Completed: | 06/06/2025
 

General Position Description:
Ensure claim accuracy and high-quality customer service through review, correction, and resubmission of rejected and delinquent claims within timely filing limits.  
 
Core Responsibilities:

  • Review all assigned Practice Management claim errors, determine the appropriate action, correct and file all claims with error status       

  • Review all assigned Clearinghouse claim errors, determine the appropriate action, correct and file all claims with error status and note actions in patients’ chart  

  • Review all assigned insurance payor rejections, determine the appropriate action, correct and re-file all rejected claims    Review and maintain the Clearinghouse workgroup list, ensure the resubmission process is complete      

  •  Ensure that all claims within assigned receivables meet timely filing requirements       

  • Assist management in identifying trends in rejection results with various insurance carriers       

  • Maintain current knowledge of assigned insurance carrier’s rules and regulations both federal and commercial       

  • Ensure that month-end goals are met in a timely manner 

  • Work with clinic supervisors and staff to improve the capture and accuracy of demographic information as well as other information critical to claim processing and reimbursement        

  • Observe safety and security procedures; promote a safe and pleasant work environment        

  • Regular attendance to ensure efficient operations      

  • Assist in questions from other departments concerning rejections  

 Other duties and responsibilities:
  •  Other duties and responsibilities as assigned.  
 Qualifications: 

  • High school graduate or equivalent. 

  • Proven ability to work in a team environment. 

  • Articulate communication skills and excellent customer service skills. 

  • Computer knowledge, e.g., Microsoft Office. Accuracy and detail orientation with high level of productivity. 

  • Familiarity with ICD-10, and CPT coding, as well as experience reviewing and understanding insurance EOBs is preferred.

Physical Demands/Work Conditions:

  •  Office environment. Sitting and keyboarding for extended periods of time. 

  • High attention to detail and ability to focus. Moderate noise level.  








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