Billing Specialist

Avance Care; Durham (NC); Hybrid; USD 42,000 - 58,000; Full time

Job summary

Avance Care is hiring a Billing Specialist to secure revenue by ensuring timely payment of claims and resolving rejections. You’ll follow up on all claims, work with payers, and support the organization’s billing functions in a busy clinical network.

The role is full-time with 8-hour weekday shifts, a hybrid schedule (4 days remote, 1 day onsite), and comprehensive benefits starting after 30 days.

Qualifications

• High School Diploma or related certificate required; post-secondary training preferred.
• 1–2 years of billing experience in a healthcare setting preferred.
• Knowledge of HCFA 1500 form is a plus.

Responsibilities

• Oversee the claim cycle from submission to resolution with accuracy.
• Resolve front-end rejections in clearinghouse and billing software.
• Research payer denials and payment variances and follow up on appeals.
• Communicate with insurance carriers via calls, portals, fax, or email to finalize resolutions.
• Assist practice locations with account, insurance, or billing inquiries.

Skills

Billing

Claims processing

Denial management

Payer portals

Insurance knowledge

Communication

Billing software

Education

High School Diploma

Job description

Overview

Exciting Career Opportunity with Avance Care!

Join ourrapidly expandingnetwork of 37 practice locations in the Triangle Area (Raleigh-Durham-Chapel Hill), the Charlotte Region, and Wilmington, NC.

Avance Careis dedicated to elevating the standard of healthcare. As one of North Carolina's largest networks of independentprimary carepractices, we offercomprehensive servicesto support the physical, mental, and emotional health of our patients.

As aBilling Specialistyou’ll secure revenue by ensuring timely payment of claimsby insurance companies, resolving both initial rejections as well as processing errorsby Avance Care payer partners and clearinghouses. You’ll also ensures maximum reimbursementto the organization by timely follow-up on all claimsand having the necessary functions to bill, collect, analyze, and adjudicate billing functions for all clinical services.

• This is a full-time role involving8 hours weekday shiftswith no weekends schedule.
• The position works a hybrid schedule with 4 days remote and 1 day onsite.
• We operate in abusy, fast-paced environment, and we seek a candidate who thrives under such conditions.
• We offer acomprehensive benefitspackage available on the first of the month following 30 days of employment.

Selected Responsibilities:

• Oversee the Claim Cycle to resolution, ensuring efficiency and accuracy
• Reviews and resolves front end rejections in Clearinghouse and Billing Software
• Research, address, and resolves all payer claim denials, account discrepancies and payment variances
• Contacts appropriate party regarding claims denial via outbound calls, insurance portals, fax, or email to ensure final resolution. Re-file or bill to patient as appropriate
• Addresses and resolves incoming phone calls from insurance companies regarding claim denials or processing
• Research and collect information to submit appeals. Follow-up on all billing related appeals
• Provide Medical Records and supporting documents to various insurance company websites to assist with claim resolutions
• Process insurance refunds and reconciles patient accounts in billing system
• Process patient payments over the phone, post payments to appropriate accounts and provides receipts
• Collaborates with Payments/Collections Team and Outsource Call Center associates regarding patient inquiries
• Collaborates with Coding Team regarding discrepancies for claim denials
• Aids Practice locations regarding account, insurance, or billing process inquiries
• Completes audit for AR work performed by Outsource associates

Candidates should have aHigh School Diploma, or post-secondary certificates in related field, preferred. Along with 1-2 years related billing experience preferred.

Other Priorities:

• Strong verbal and written communication
• Knowledge of insurance practices
• Payer policy research and analysis skills, preferred
• Denial analysis and trending skills, preferred
• Knowledge of the HCFA 1500 claim form, preferred

If you are excited to join a growing organization focused on changing the way healthcare is delivered to patients in North Carolina,

Avance Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, gender identification, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state or local law.