Billing Specialist

Community Clinic • Silver Spring, MD

7d

About The Position

The Billing Specialist performs billing and revenue-cycle responsibilities requiring data analysis, critical evaluation, and sound judgment. The role maintains billing software, prepares and transmits claims, appeals denied claims, records late payments, and supports accurate billing and timely reimbursement. The specialist works with patients, insurance companies, payers, and clinics to resolve account issues, meet collection goals, and maintain accounts receivable over 120 days at or below target levels. The position also maintains confidentiality and protects health information in accordance with HIPAA requirements.

Requirements

• High school diploma or equivalent required; equivalent experience may also qualify.
• At least two years of experience as a medical biller or coder.
• Proficiency in Microsoft Office.
• Strong organizational, verbal, and written communication skills.
• Strong attention to detail and ability to work in a fast-paced environment.
• Solid understanding of billing software and electronic medical record systems.
• Current knowledge of insurance guidelines, including Medicare and state Medicaid programs.
• Proficiency in CPT and ICD-10 coding.
• Strong multitasking, time-management, problem-solving, and organizational abilities.
• Advanced computer literacy and strong interpersonal skills.
• Thorough understanding of the revenue cycle, including claims processing, denial resolution, reimbursement, and accounts receivable management.
• Knowledge of billing, reimbursement procedures, third-party regulations, medical terminology, and healthcare governing agency policies and procedures.
• Ability to work independently and collaboratively within a team.
• Ability to interpret accounts and records, develop spreadsheets, generate reports, perform basic bookkeeping, and compile statistical data.
• Proficiency in operating a personal computer and office equipment; ability to prepare reports and maintain organized records and files.
• Ability to extract relevant information from conversations and documents.
• Commitment to maintaining confidentiality and protecting health information in compliance with HIPAA.

Nice To Haves

• Associate’s (AA) or Bachelor’s (BS) degree preferred, or equivalent experience.
• Medical Billing/Coding certification is a plus.
• Experience and/or knowledge of FQHC billing guidelines and procedures preferred.
• Experience with eClinicalWorks (eCW) is a plus.

Responsibilities

• Review and research patient visit forms, correcting amounts due from patients and insurance as needed.
• Contact insurance companies to verify coverage, determine payor schedules, and obtain benefit information.
• Calculate bills showing amounts payable by insurance and patients.
• Review bills for accuracy and completeness and obtain missing information.
• Prepare, review, and transmit claims using billing software, including electronic and paper claims.
• Follow up on unpaid claims within standard billing-cycle timeframes.
• Respond promptly and professionally to patient and insurance inquiries about assigned accounts.
• Audit claims, accounts, payers, and vouchers; prepare adjustment reports and resolve payment issues.
• Support clinics and attend external meetings as required.
• Investigate and correct errors, documenting inconsistencies in practice-management system entries, documents, and reports.
• Maintain working knowledge of HCPCS, CPT, ICD, and revenue codes using appropriate resources.
• Meet productivity goals established by management.
• Assist colleagues and complete other assigned duties after finishing assigned work.
• Coordinate communications with payers to support accurate billing, improve reimbursement, meet cash-collection targets, and keep A/R over 120 days at or below target levels.
• Maintain confidentiality and protect the privacy and security of protected health information in compliance with HIPAA.
• Perform other duties and special projects as assigned.

Benefits

• Extensive benefits plan including PTO.
• 403B retirement plan.
• Tuition reimbursement opportunities.
• Continuing education assistance, which may be used toward certifications, certification renewal, or conference attendance.
• Providers are insured for malpractice under FTCA.

What This Job Offers

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