Billing and Benefits Specialist

CONSULTANTS IN GASTROENTEROLOGY PA • WEST COLUMBIA, SC

5d

About The Position

The Billing & Benefits Specialist manages patient insurance verification, prior authorizations, medical claim submissions, payment posting, and insurance and patient benefit inquiries. The role serves as a primary connection between clinical services—including office visits, colonoscopies, and endoscopies—insurance payers, and patients, supporting clean-claim reimbursement and clear financial communication.

The position is with Consultants in Gastroenterology, a specialized medical practice providing digestive health care, including cancer screenings, colonoscopies, upper endoscopies, and endoscopic ultrasounds. The role is full-time, Monday through Friday, for 40 hours per week. Hybrid or fully remote options are available after an initial one to two weeks of on-site training in West Columbia, South Carolina.

Requirements

• High school diploma or GED.
• At least 2 years of medical billing, insurance verification, or revenue cycle experience.
• Proficiency with CPT, ICD-10, and HCPCS coding for GI procedures and office evaluations.
• Familiarity with major commercial insurance portals and Medicare and Medicaid guidelines.
• Experience with Electronic Health Record (EHR) and Practice Management (PM) software.
• Strict adherence to HIPAA regulations and protected health information (PHI) standards.
• Strong verbal and written communication skills, including the ability to assist distressed or confused patients.
• High attention to detail and analytical problem-solving skills.

Nice To Haves

• Associate degree, business or accounting coursework, or a medical billing/coding certificate.
• Experience in a private physician practice or specialty clinic.
• Gastroenterology or surgical center experience.

Responsibilities

• Verify active patient insurance coverage, deductible status, and out-of-pocket maximums before scheduled office visits and GI procedures.
• Obtain timely pre-authorizations and precertifications from commercial payers, Medicare Advantage, and Medicaid.
• Explain copays, coinsurance, deductibles, and other financial responsibilities to patients in a transparent and compassionate manner.
• Enter and review charges based on clinical documentation, linking CPT, ICD-10, and HCPCS codes appropriately.
• Assemble and electronically submit clean claims to commercial insurers, Medicare, and Medicaid.
• Investigate denied or rejected claims, compile necessary clinical records, and submit written or peer-to-peer appeals.
• Post insurance and patient payments, reconcile ledgers against Explanations of Benefits (EOBs), and track accounts receivable.
• Respond to billing inquiries, resolve statement disputes, and arrange reasonable payment plans.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED