Billing Specialist

AFC Urgent Care Portland/Vancouver•Tigard, OR

14h•Onsite

About The Position

AFC Urgent Care Clinics is seeking a detail-oriented and motivated Billing Specialist to join our Revenue Cycle team at our headquarters in Tigard, Oregon. This is an entry- to mid-level billing position ideal for a candidate with hands-on experience in medical billing, including Workers' Compensation (WCOMP) experience, working denials, insurance eligibility, payment posting, handling patient inquiries and calls, and account receivable collections. The Billing Specialist will play a key role in supporting day-to-day billing operations, ensuring timely follow-up on claims, accurate payment posting, and excellent service to our patients and internal team members. This position is based on-site at our Tigard, OR headquarters, with the possibility of a hybrid work arrangement in the future as the role develops.

Requirements

Minimum of 2–5 years of experience in medical billing, preferably in an urgent care, primary care, or multi-specialty outpatient setting.
Demonstrated experience working Workers' Compensation billing and A/R, including adjuster follow-up, denial management, and claims resolution.
Experience posting payments, ERAs, and paper checks in a practice management or EHR system.
Proficiency with insurance eligibility and claim status portals (Availity, OneHealthPort, Medicare, Oregon Medicaid, and/or Washington Medicaid preferred).
Strong understanding of medical billing processes, payer guidelines, and claim lifecycle.
Excellent written and verbal communication skills with the ability to interact professionally with payers, adjusters, and patients.
High attention to detail, strong organizational skills, and the ability to prioritize in a fast-paced environment.
Proficiency with Google Workspace, including Google Docs, Google Sheets, and Gmail.
Ability to reliably commute to and work on-site at our Tigard, OR headquarters.
Working knowledge of Workers' Compensation billing regulations and payer-specific requirements.
Ability to read and interpret EOBs, ERAs, and payer correspondence.
Strong problem-solving skills and the ability to work independently with minimal supervision.
Demonstrated ability to maintain patient confidentiality and comply with HIPAA regulations.
A collaborative, team-first attitude with the ability to adapt in a growing clinic environment.
Consistent, reliable attendance and a professional demeanor.
High school diploma or equivalent required.

Nice To Haves

Experience with multi-state payer environments (Oregon and Washington).
Familiarity with urgent care billing and common procedure codes associated with urgent care visits (CPT, ICD-10).
Prior experience conducting patient account audits and resolving complex billing discrepancies.

Responsibilities

Manage and work the WCOMP accounts receivable (A/R) queue, including identifying and resolving claim denials and underpayments.
Follow up directly with Workers' Compensation adjusters and WCOMP payers to obtain payment status, resolve outstanding balances, and escalate unresolved claims as appropriate.
Research and appeal denied WCOMP claims by gathering supporting documentation and submitting timely appeals in accordance with payer guidelines.
Monitor claim aging reports and prioritize follow-up activity to reduce outstanding WCOMP A/R days.
Document all account activity, follow-up contacts, and resolution notes thoroughly in the practice management (PM) system.
Post insurance payments and Electronic Remittance Advices (ERAs) accurately and timely into the PM system.
Post paper checks, EOBs, and patient payments, ensuring all transactions are balanced and correctly applied to patient accounts.
Identify and resolve posting discrepancies, contractual adjustments, and balance transfers in a timely manner.
Respond to patient inquiries via phone and messaging regarding billing statements, insurance processing, balances, and payment options in a professional and empathetic manner.
Conduct patient account audits to identify billing errors, misapplied payments, or discrepancies and make appropriate corrections.
Assist patients in understanding their Explanation of Benefits (EOBs) and coordinate with insurance payers on their behalf when needed.
Verify patient insurance eligibility and check claim status using payer portals including Availity, OneHealthPort, Medicare, Oregon Medicaid (OHA), and Washington Medicaid (Apple Health).
Proactively identify eligibility issues and communicate findings to appropriate team members to prevent billing delays.
Print and mail claims and itemized statements to patients and payers in accordance with office procedures.
Assist the billing team with day-to-day administrative billing tasks as needed.
Maintain organized billing records and documentation in compliance with HIPAA and company policies.
Participate in team meetings, training sessions, and process improvement initiatives.
Perform other related duties as assigned by the Billing Manager.