Physician Practice Billing Specialist

Under the general direction of the Billing Services Manager, the Director of Business Services, and the Physician Practice Business Office Supervisor, the Practice Billing Specialist is responsible for creating claims, billing payers, reviewing EOBs, posting payments, and completing follow-up work necessary for account reimbursement. This role also includes appeals, patient responsibility statements, collection efforts, and communication with providers regarding missing information or coding issues.

Key responsibilities include:

• Preparing and submitting clean claims to insurance companies electronically or by paper
• Answering questions from patients and insurance companies
• Identifying and resolving patient billing complaints
• Preparing, reviewing, and sending patient statements
• Evaluating patient financial status and establishing budget payment plans
• Monitoring delinquent accounts and recommending them for collections when appropriate
• Contacting patients by phone, correcting and resubmitting claims to third-party payers
• Processing payments from insurance companies
• Translating patient information into alphanumeric and numeric medical codes
• Monitoring codes and educating staff on appropriate usage
• Investigating and correcting rejected and denied claims
• Participating in educational activities and staff meetings
• Maintaining strict confidentiality and compliance with HIPAA guidelines and regulations