Billing Specialist

Page Mechanical Group, Inc.; The Woodlands (TX); On-site; USD 45,000 - 60,000; Full time

Job summary

A healthcare provider in The Woodlands, Texas is seeking a skilled Billing Specialist responsible for accurate medical claims submission and follow-up. The role encompasses verifying insurance eligibility, ensuring HIPAA compliance, and resolving claim issues. Candidates should have familiarity with billing processes and be able to maintain patient confidentiality. This position is pivotal in supporting efficient revenue cycle operations and communicating effectively with patients and payers.

Responsibilities

• Prepare and submit clean claims to insurance payers.
• Verify patient insurance eligibility and coverage.
• Research claim denials and correct errors.

Job description

Job Summary

The Billing Specialist is responsible for accurate and timely submission of medical claims, and follow-up with payers and patients. This role ensures compliance with HIPAA and payer regulations while supporting efficient revenue cycle operations.

Key Responsibilities

• Prepare, review, and submit clean claims to insurance payers (CMS-1500 and/or UB-04)
• Verify patient insurance eligibility and coverage
• Ensure accuracy of patient demographics, charges, and modifiers
• Submit claims electronically and track claim status
• Research claim denials and rejections
• Correct errors and resubmit claims in a timely manner
• Prepare and submit appeals with supporting documentation
• Generate and review patient statements
• Respond to patient billing inquiries professionally and clearly
• Maintain compliance with HIPAA Privacy and Security Rules
• Protect the confidentiality of all patient information
• Out of network billing preferred but not required
• Knowledge of Federal and State guidelines regarding NSA and TDI claims