Billing & Benefits Specialist — Hybrid/Remote

Consultants in Gastroenterology - West Columbia; West Columbia (SC); Hybrid; USD 45,000 - 65,000; Full time

Job summary

Consultants in Gastroenterology - West Columbia seeks a Billing & Benefits Specialist to manage patient insurance verification, prior authorizations, medical claim submissions, and payment posting. You will serve as the bridge between clinical services, payers, and patients to maximize clean-claim reimbursement and clear financial communication.

The role requires 2+ years in medical billing; familiarity with GI CPT/ICD-10 coding, HIPAA, and EHR/PM software is essential.

Qualifications

• High school diploma or GED required; associate degree, business/accounting coursework, or medical billing/coding certificate preferred.
• 2+ years of medical billing, insurance verification, or revenue cycle experience, ideally in a private physician practice or specialty clinic.

Responsibilities

• Verify Coverage: Confirm active patient coverage, deductible status, and out-of-pocket maximums prior to visits and GI procedures.
• Prior Authorizations: Secure timely pre-authorizations and precertifications from commercial payers, Medicare Advantage, and Medicaid.
• Benefit Explanations: Educate patients on their financial responsibility, co-pays, coinsurance, and deductibles clearly.
• Charge Capture: Enter and review charges with CPT/ICD-10/HCPCS linkage.
• Claim Submission: Submit clean claims to commercial insurers, Medicare, and Medicaid.
• Denials & Appeals: Investigate denials and submit appeals with appropriate documentation.
• Payment Posting & Reconciliation: Post payments, reconcile ledgers against EOBs, monitor A/R.
• Patient Collections: Handle billing inquiries and set up reasonable payment plans.

Skills

Medical billing

Insurance verification

Revenue cycle management

HIPAA compliance

Communication skills

Education

High school diploma or GED

Associate degree or medical billing/coding certificate

Tools

EHR systems

Practice Management software

CPT/ICD-10/HCPCS coding knowledge

Job description

Consultants in Gastroenterology - West Columbia seeks a Billing & Benefits Specialist to manage patient insurance verification, prior authorizations, medical claim submissions, and payment posting. You will serve as the bridge between clinical services, payers, and patients to maximize clean-claim reimbursement and clear financial communication.

The role requires 2+ years in medical billing; familiarity with GI CPT/ICD-10 coding, HIPAA, and EHR/PM software is essential.