Health Specialist Jobs

About The Position

Requirements

• Bachelor’s degree in healthcare administration, business, or a related field, or equivalent experience.
• At least 2 years of experience in medical billing and insurance verification.
• Proficiency in medical billing software.
• Strong knowledge of CPT and ICD-10 coding.
• Familiarity with HIPAA regulations and privacy standards.
• Strong attention to detail, problem-solving, communication, and technical skills, including use of Excel and data analysis tools.

Responsibilities

• Verify insurance coverage and accurately load insurance information for billing.
• Submit claims to the billing partner.
• Create invoices for case rates and other billing scenarios as needed.
• Review and correct patient demographic information, including dates of birth, addresses, and member IDs.
• Conduct claim audits and reconciliations to ensure services are accounted for and billed correctly.
• Research uninsured and unknown-insurance cases to identify potential coverage.
• Assist with implementing and testing billing automation processes.
• Conduct ongoing audits of billing automations for accuracy and efficiency.
• Work with Operations to identify opportunities to improve front-end data collection.
• Serve as a subject matter expert for Navigators on insurance-related questions.
• Communicate billing irregularities to health plans and work with them to resolve issues.

Benefits

• Competitive base salary.
• Market-competitive healthcare coverage, including medical, dental, vision, life, and disability.
• Opportunity to grow alongside talented and professional colleagues.
• Opportunity to be part of a dynamic, mission-driven organization.