Billing and Benefits Specialist

CONSULTANTS IN GASTROENTEROLOGY • WEST COLUMBIA, SC

5d • Hybrid

About The Position

Consultants in Gastroenterology is a specialized medical practice providing digestive health care, including cancer screenings, colonoscopies, upper endoscopies, and endoscopic ultrasounds. The Billing & Benefits Specialist supports the practice’s revenue cycle and patient financial communication by coordinating insurance verification, prior authorizations, medical claim submissions, payment posting, and benefits inquiries. The role bridges clinical services, insurance payers, and patients to support clean-claim reimbursement and clear communication about financial responsibility.

This is a full-time, 40-hour-per-week position, Monday through Friday. Hybrid or fully remote options are available after an initial one to two weeks of onsite training in West Columbia, South Carolina. The position reports to the Director of Operations.

Requirements

• High school diploma or GED.
• At least 2 years of medical billing, insurance verification, or revenue cycle experience; ideally in a private physician practice or specialty clinic.
• Proficiency in CPT, ICD-10, and HCPCS coding for gastrointestinal 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 standards.
• Strong verbal and written communication skills for assisting 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.
• Gastroenterology or surgical center experience.

Responsibilities

• Verify active patient coverage, deductible status, and out-of-pocket maximums before scheduled office visits and specialized gastrointestinal procedures.
• Obtain timely pre-authorizations and precertifications from commercial payers, Medicare Advantage, and Medicaid for office-based or ambulatory surgery center procedures.
• Explain patients’ financial responsibilities, including copays, coinsurance, and deductibles, in a transparent and compassionate manner.
• Enter and review charges using clinical documentation, ensuring appropriate linkage of CPT, ICD-10, and HCPCS codes.
• Assemble and electronically submit clean claims to commercial insurers, Medicare, and Medicaid.
• Investigate denied or rejected claims, compile relevant clinical notes and records, and submit written or peer-to-peer appeals.
• Post insurance and patient payments, reconcile ledgers against Explanations of Benefits, and track accounts receivable.
• Respond to billing inquiries, resolve statement disputes, and arrange reasonable patient payment plans.

What This Job Offers

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