Billing Specialist II: Claims & Payer Expert

Phelps Health; Rolla (MO); On-site; USD 42,000 - 56,000; Full time

Job summary

Phelps Health in Rolla, MO is seeking a Billing Specialist II to manage claims from entry to submission and to support patient inquiries on accounts. You will collaborate with the Billing Supervisor to ensure timely processing of insurance claims and accurate data entry.

Responsibilities include handling denials and appeals, verifying benefits, and ensuring HIPAA compliance while maintaining high data integrity and payer communications.

Qualifications

• 3 years medical billing experience required.
• Associate Degree in health care or related field or billing certification preferred.
• High School diploma or GED required.

Responsibilities

• Enters information necessary for insurance claims such as patient insurance and insurance ID.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper forms.
• Answer patient questions regarding insurance claims processing and coverage.
• Follow up with insurance companies on unpaid or rejected claims and resubmit as needed.
• Prepare appeal letters to insurance carriers when claims are denied.
• Verify patient benefits eligibility and coverage.
• Ensure claims are submitted clean on first pass and refer coding issues to the appropriate staff.
• Comply with HIPAA guidelines when handling patient information.

Job description

Phelps Health in Rolla, MO is seeking a Billing Specialist II to manage claims from entry to submission and to support patient inquiries on accounts. You will collaborate with the Billing Supervisor to ensure timely processing of insurance claims and accurate data entry.

Responsibilities include handling denials and appeals, verifying benefits, and ensuring HIPAA compliance while maintaining high data integrity and payer communications.