992 Billing/Insurance Specialist

A Brighter Future Healthcare Services•Fayetteville, NC

About The Position

ABF Healthcare Services, Inc. is a patient-centered primary care organization committed to delivering high-quality healthcare services in a professional and supportive environment. We are currently seeking a skilled and detail-oriented Billing & Insurance Specialist to join our Revenue Cycle team. This position plays a vital role in ensuring accurate billing, timely reimbursement, and optimal revenue performance. The Billing & Insurance Specialist is responsible for managing all aspects of insurance billing, claims processing, and revenue cycle operations within a primary care setting. The ideal candidate will possess in-depth knowledge of medical billing processes, payer requirements, and regulatory compliance standards. This role requires strong analytical skills, attention to detail, and the ability to effectively communicate with patients, providers, and insurance representatives.

Requirements

High school diploma or equivalent required.
Minimum of 2–3 years of medical billing and revenue cycle experience required.
Primary care billing experience is required.
Proven experience billing Medicare, Medicaid, and commercial insurance carriers.
Experience managing both insurance-based and cash-pay accounts.
Strong knowledge of CPT, ICD-10, and HCPCS coding.
Proficiency in medical billing software and electronic health record (EHR) systems.
Working knowledge of accounts receivable management and payment posting.
Proficient in Microsoft Office Suite (Excel, Word, Outlook).
Exceptional attention to detail and accuracy.
Strong organizational and time management skills.
Analytical thinking and problem-solving abilities.
Professional communication and interpersonal skills.
Ability to work independently and collaboratively in a team-oriented environment.

Nice To Haves

Associate’s degree or higher in Healthcare Administration, Business, or a related field preferred.
Certified Professional Biller (CPB)
Certified Medical Reimbursement Specialist (CMRS)
Or equivalent professional billing certification

Responsibilities

Prepare, review, and submit accurate and timely claims to Medicare, Medicaid, and commercial insurance carriers.
Ensure all claims are compliant with payer-specific guidelines and coding requirements.
Monitor claim status and resolve rejections, denials, and payment discrepancies.
Perform follow-up on outstanding accounts receivable and reprocess claims as necessary.
Identify patterns in denials and implement corrective actions to prevent recurrence.
Manage billing processes for cash-based services, ensuring accurate invoicing and timely collection of payments.
Maintain detailed documentation of all patient payments and financial transactions.
Reconcile daily payment postings and ensure accurate financial reporting.
Oversee the full revenue cycle process from patient registration and charge capture to final reimbursement.
Post payments accurately and reconcile accounts.
Analyze accounts receivable reports and implement strategies to reduce AR days and improve cash flow.
Recommend and implement process improvements to enhance billing efficiency and minimize errors.
Respond to patient inquiries regarding billing statements, insurance coverage, and payment options.
Establish and manage payment plans in accordance with company policies.
Deliver professional and courteous customer service to ensure a positive patient experience.
Ensure compliance with all applicable federal, state, and local healthcare regulations, including HIPAA and payer-specific requirements.
Maintain accurate, thorough, and confidential billing records.
Assist with internal audits and ensure documentation supports billed services.
Stay current on coding updates, payer policies, and regulatory changes.
Collaborate closely with front desk staff, clinical teams, and administrative personnel to ensure accurate patient demographics and charge entry.
Participate in team meetings and contribute to process improvement initiatives.
Support cross-training efforts within the revenue cycle team.