Billing Specialist

High-Country-Community-Health-2; Boone (NC); On-site; USD 42,000 - 62,000; Full time

Job summary

High Country Community Health is seeking a Billing Specialist to join our revenue cycle team. You will work to ensure prompt, accurate processing of claims, verification of eligibility, and posting of payments across multiple sites.

The role requires strong attention to detail, teamwork, and excellent communication with patients and insurers. The ideal candidate has 2+ years in medical office billing, proficiency in Word/Excel, and a willingness to learn EPIC.

Qualifications

• High school diploma or GED required; Billing certificate is a plus.
• Two years of medical office experience; billing experience a plus.
• Proficiency with computers, Windows/Office (Word & Excel) required.
• Excellent customer service to internal and external customers.
• Willingness to work cooperatively in a team setting.
• Ability to ensure accuracy and thoroughness in billing and documentation.
• Ability to work with minimal supervision and maintain strong work ethic.
• Clear oral and written communication skills.
• Ability to make timely, informed decisions affecting billing and revenue.
• EPIC knowledge is strongly preferred.

Responsibilities

• Data management and verification of patient information.
• Check eligibility and verify benefits for procedures.
• Review patient bills for accuracy and completeness; obtain missing data.
• Prepare, review, and transmit claims via billing software (electronic/paper).
• Perform encounter reviews to ensure codes/charges are correct.
• Monitor daily schedules to capture all charges.
• Follow up on unpaid claims within standard billing cycles.
• Verify insurance payments for accuracy and contract compliance.
• Contact insurers about any payment discrepancies.
• Bill secondary/tertiary insurances as needed.
• Review accounts for patient follow-up related to insurance.
• Manage claim denials: refile, research, and appeal.
• Answer patient or insurer queries about accounts.
• Set up patient payment plans and manage collections.
• Update cash spreadsheets and run collection reports.
• Post insurance payments as assigned and ensure daily postings.
• Collaborate with sites to ensure accurate postings.
• Audit Sliding Fee Scale applications; ensure complete documentation.
• Serve as SFS subject matter expert and integrate into EHR.
• Coordinate with Site Leads to correct errors; follow-up on fixes.
• Assist Billing Team with special projects as needed.
• Identify patients with expiring slides after SFS claims catch up.
• Perform other duties as assigned.

Skills

Customer service

Teamwork

Oral and written communication

Attention to detail

Decision making

EPIC knowledge

Education

High school diploma or GED

Billing certificate

Tools

Microsoft Word

Microsoft Excel

Job description

Title of Position:

Billing Specialist

Nature of Position:

The billing specialist will be responsible for working with the team to ensure that claims are processed promptly and efficiently.

II. Responsible to:

Director of Revenue Cycle

III. Responsibilities:

• Data Management Specialist
• Checking eligibility and benefits verification for office procedures.
• I'm looking over the patient bills for accuracy and completeness, and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Encounter Review of charts to ensure codes/charges are accurate.
• Working daily schedules from offices to ensure all charges are captured.
• Following up on unpaid claims within the standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Claim Denial Management: refiling, researching, and appealing denied claims.
• Answer all patient or insurance telephone questions about assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating cash spreadsheets, and running collection reports.
• Posting all insurance payments received, as assigned.
• Working with sites to ensure that payments are posted daily and information is accurate
• Daily posting and balancing, as assigned
• Auditing Sliding Fee Scale (SFS) applications for all medical sites. Ensures applications are complete and the front desk staff has collected proper documentation.
• Become an SFS subject matter expert to handle all SFS questions/issues.
• Ensures SFS is properly entered into EHR
• Works with Site Leads on any errors identified
• Follow up on errors to make sure corrections have been made
• Works with the Billing Team to ensure claims have slid correctly after corrections are made
• Assist the Billing Team with special projects as needed
• Once SFS claims are caught up, assist the front desk with identifying patients with expiring slides.
• Other duties as assigned

Requirements

A. High school diploma or GED; Coding/Billing certificate a plus.

B. Two years of medical office experience, billing experience a plus.

C. Competent with computers including experience in Microsoft Windows/Office programs, specifically

Microsoft Word and Excel.

D. Excellent customer service to both internal and external customers

E. Willingness to work cooperatively in a team setting

F. Ability to demonstrate accuracy and thoroughness ensuring the highest possible quality.

G. Ability to maintain a strong work ethic without direct supervision at all times

H. Effective oral and written communication

I. Ability to make timely, informed decisions that consider the facts, goals, constraints, and risks related to all aspects of the organization

J. EPIC knowledge is strongly preferred.