Healthcare Billing & Claims Specialist

HopeHealth, Inc.; Florence (SC); On-site; USD 42,000 - 54,000; Full time

Job summary

HopeHealth, Inc. in Florence, SC is seeking a Billing Specialist to accurately process healthcare claims and secure reimbursement from insurers and government programs.

The role requires attention to detail, excellent communication, and the ability to work under pressure while coordinating with patients, clinical and administrative staff. Responsibilities include validating claim information, applying adjustments, scrubbing claims, filing electronic and paper claims daily, and handling denials

Qualifications

• High School Diploma or GED required; associates degree preferred.
• 1-2 years of medical billing and follow-up experience desired.
• CPC and/or CPB certification highly desired but not required.
• eClinicalWorks experience preferred.
• Proficient with Microsoft Office Suite specifically Excel, Word, and Power Point.
• Advance and current working knowledge of ICD-10, CPT, and HCPCS codes.
• Current knowledge of insurance payer coding and reimbursement guidelines.

Responsibilities

• Validate the accuracy of claim information and ensure efficient billing and follow-up.
• Apply approved adjustments to accounts per policy.
• Scrub claims for errors and mark corrections per payer guidelines.
• File electronic and hard copy claims daily.
• Process mail and correspondence to secure payment; rebill within 2 business days when needed.
• Assist other staff with questions on patient payments, remittance advice, or related inquiries.
• Answer calls from patients and insurers; respond within 24 hours.
• Address actions within 48 hours; urgent actions within 24 hours.
• Maintain daily account and follow-up worklists and pursue follow-up per guidelines.
• Attend departmental meetings and continuing education opportunities.
• Demonstrate a positive patient/customer service attitude.

Skills

Medical billing

Insurance payer coding

ICD-10/CPT/HCPCS

Customer service

Communication

Detail orientation

Multitasking

Team collaboration

Data entry

Adaptability

Education

High School Diploma or GED

Associates degree preferred

CPC/CPB certification desirable

Tools

eClinicalWorks

Microsoft Excel

Microsoft Word

PowerPoint

Job description

HopeHealth, Inc. in Florence, SC is seeking a Billing Specialist to accurately process healthcare claims and secure reimbursement from insurers and government programs.

The role requires attention to detail, excellent communication, and the ability to work under pressure while coordinating with patients, clinical and administrative staff. Responsibilities include validating claim information, applying adjustments, scrubbing claims, filing electronic and paper claims daily, and handling denials