Billing & Claims Specialist I — Patient Inquiry Expert

Commonwealth Health; Wilkes-Barre (Luzerne County); Sur place; USD 36 000 - 48 000; Plein temps

Résumé du poste

Commonwealth Health in Wilkes-Barre is seeking a Billing Specialist I to manage insurance claims processing, follow-up, and payer communications to ensure timely reimbursement. You will collaborate with clinic staff and coding teams to optimize revenue cycle operations.

The role focuses on handling the incoming call queue, resolving patient billing questions, and maintaining HIPAA-compliant records in the practice management system.

Qualifications

• Associate degree in healthcare related field or technical school for medical billing and coding preferred.
• 0-2 years of experience in medical billing, insurance claims processing, or revenue cycle management required.

Responsabilités

• Submits and processes claims accurately and efficiently, ensuring compliance with payer requirements and company policy.
• Communicates with insurance companies, patients, and other stakeholders to resolve billing inquiries and maintain account status.
• Reviews and reconciles credit balances, reclassifies revenue, and processes adjustments per transaction coding guidelines.
• Monitors and resolves claim denials and rejections, identifying trends and implementing corrective actions.
• Reviews and corrects claim filing edits based on payer requirements and electronic health record (EHR) system alerts.
• Maintains accurate documentation of all billing actions in the practice management system.
• Gathers, updates, and communicates billing policy changes, ensuring accessibility of up-to-date reference materials.
• Collaborates with management, clinic staff, and coding teams to ensure proper billing and collection procedures.
• Assists patients and insurance representatives with billing-related questions while maintaining professionalism.
• Ensures compliance with HIPAA regulations and maintains confidentiality of patient financial and medical information.
• Performs other duties as assigned.
• Complies with all policies and standards

Connaissances

Billing knowledge

Communication skills

Analytical thinking

HIPAA compliance

Attention to detail

Multitasking

Formation

Associate degree in healthcare or medical billing/coding

Outils

Athena

Cerner

Ingenious Med

Description du poste

Commonwealth Health in Wilkes-Barre is seeking a Billing Specialist I to manage insurance claims processing, follow-up, and payer communications to ensure timely reimbursement. You will collaborate with clinic staff and coding teams to optimize revenue cycle operations.

The role focuses on handling the incoming call queue, resolving patient billing questions, and maintaining HIPAA-compliant records in the practice management system.