Medical Billing Specialist
About The Position
The Billing Specialist plays a critical role in integrating billing and revenue cycle best practices for all payor groups. This position focuses on front-end claims management, collaborating with front-end teams and other members of the revenue cycle team to ensure the accurate and timely submission of claims. The specialist will be responsible for gathering requisitions, entering patient data, verifying insurance information, resolving billing discrepancies, and ensuring proper billing, with the ultimate goal of optimizing initial claims accuracy and revenue flow. This role requires a strong understanding of medical billing, coding practices, and healthcare regulations, along with a high attention to detail and excellent communication skills.
Requirements
- High school diploma or equivalent required
- Experience in medical billing, patient registration, healthcare data entry, or revenue cycle operations required
- Familiarity with laboratory or pathology billing workflows preferred
- Experience using healthcare billing or revenue cycle systems, preferably NovoPath and/or XiFin
- Knowledge of insurance types, billing terminology, and payer requirements, including commercial insurance, Medicare, and Medicaid
- Basic understanding of HIPAA regulations and patient confidentiality standards
- Strong attention to detail with a focus on data accuracy and integrity
- Ability to identify, research, and resolve billing and data discrepancies efficiently
- Experience working in high-volume error queues, billing correction workflows, or unbillable account resolution preferred
- Strong analytical, organizational, and problem-solving skills
- Effective written and verbal communication skills with the ability to collaborate across departments
- Ability to manage multiple priorities and meet deadlines in a fast-paced laboratory environment
Nice To Haves
- Associate's degree preferred
- Familiarity with laboratory or pathology billing workflows preferred
- Experience working in high-volume error queues, billing correction workflows, or unbillable account resolution preferred
Responsibilities
- Answers and directs phone calls
- Responds to messages in a timely manner
- Maintains requisitions and obtains missing documents
- Links requisitions to appropriate accessions
- Data entry of patient demographics and insurance information
- Corresponds with hospitals and doctor's offices to obtain missing information
- Reviews and resolves daily Error Processing worklists (bad addresses, no authorization, eligibility undetermined, etc.) in a timely manner
- Pro-actively identifies clearinghouse rejection trends
- Forwards qualifying accounts to third party collections agency as needed
- Achieves or exceeds daily KPIs
- Always adheres to HIPAA compliance, including when accessing client portals
- Reviews various reports, including data entry, error processing, and clearing house rejections as instructed
- Floats between front-end tasks to ensure a seamless, efficient, and accurate flow of the revenue cycle
- Supports positive change in the department
- Supports the team to improve collections, communicate issues, and implement ideas
- Supports internal and external audits by providing necessary documentation and addressing any audit findings
- All other duties as assigned
Benefits
- 401(k) includes an employer match up to 4%
- Robust health plans including dental, vision, life, and mental health support
- Generous annual vacation and sick time
- 10 paid holidays
- Annual scrub allowance for Lab roles
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
