Insurance Verification & Billing Specialist

Eastlake Cardiovascular, PC; Saint Clair Shores (MI); Presencial; USD 42.000 - 54.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive benefits

Short-Term Disability

Paid holidays

PTO

8-hour shifts (no nights/weekends)

Descripción de la vacante

Eastlake Cardiovascular, P.C. in St. Clair Shores, MI is seeking an Insurance Verification & Billing Specialist. The role verifies insurance, supports authorizations, submits claims, and resolves billing issues. As the department grows, cross-training for Remote Patient Monitoring (RPM) billing will be added.

The ideal candidate has medical billing experience, strong attention to detail, and the ability to support multiple areas of the billing process.

Formación

• High school diploma or equivalent required.
• Previous experience in medical billing, insurance verification, revenue cycle, or a related healthcare role.
• Strong attention to details and accuracy.
• Excellent organizational and time management skills.
• Ability to manage multiple priorities and meet deadlines.
• Strong written and verbal communication skills.
• Ability to work independently and as part of a team.
• Experienced with electronic medical records, billing systems, and Microsoft Office applications.
• Ability to maintain patient confidentiality and follow HIPAA requirements.

Responsabilidades

• Verify patient insurance eligibility and benefits prior to services.
• Obtain and assist with obtaining required authorizations and referrals, including global referrals.
• Review coverage, deductibles, copayments, and other payer requirements.
• Submit accurate medical claims and correct claims as needed.
• Answer and respond to calls on the billing phone line, assisting patients and staff with billing questions and concerns.
• Review EOBs and payment information.
• Follow up on unpaid, rejected, and denied claims.
• Research and resolve billing and insurance issues.
• Post and accurately apply patient and insurance payments to accounts, including reviewing and resolving payment discrepancies.
• Maintain accurate notes and documentation.
• Communicate with insurance companies, patients, providers and internal teams regarding billing issues.
• Follow company billing procedures and HIPAA requirements.
• Cross-train with the Remote Patient Monitoring (RPM) billing processes.
• Provide backup coverage and overflow support for RPM billing when needed.
• Review RPM accounts for required information and documentation.
• Assist with RPM claim submission, corrections, denials, and follow-ups.
• Review RPM related claims for accuracy and assist with correcting rejected or denied claims.
• Support follow up on unpaid or denied RPM claims and assist with identifying recurring issues.
• Work with RPM team to resolve billing issues and discrepancies.

Conocimientos

Attention to detail

Organizational skills

Time management

Communication skills

EMR systems

Microsoft Office

Educación

High school diploma

Herramientas

Electronic Medical Records

Microsoft Office

Descripción del empleo

Eastlake Cardiovascular, P.C.

Location: St. Clair Shores, MI (on-site)

Job Type: Full Time

Position Summary

The Insurance Verification & Billing Specialist is responsible for verifying insurance, supporting authorizations, submitting and following up on claims, and helping resolve billing issues. As the department grows, this position will also be cross-trained to provide backup and overflow support for Remote Patient Monitoring (RPM) billing as needed.

The ideal candidate has medical billing experience strong attention to detail, and the ability to learn and support multiple areas of the billing process.

Eastlake Cardiovascular, P.C. offers

• Competitive Benefits, including medical, dental, vision through BCBSM
• Short-Term Disability (STD)
• Paid holidays
• PTO
• A weekly 8-hour shift schedule no nights or weekends
• Verify patient insurance eligibility and benefits prior to services.
• Obtain and assist with obtaining required authorizations and referrals, including global referrals.
• Review coverage, deductibles, copayments, and other payer requirements.
• Submit accurate medical claims and correct claims as needed.
• Answer and respond to calls on the billing phone line, assisting patients and staff with billing questions and concerns.
• Review EOBs and payment information.
• Follow up on unpaid, rejected, and denied claims.
• Research and resolve billing and insurance issues.
• Post and accurately apply patient and insurance payments to accounts, including reviewing and resolving payment discrepancies.
• Maintain accurate notes and documentation.
• Communicate with insurance companies, patients, providers and internal teams regarding billing issues.
• Follow company billing procedures and HIPAA requirements
• Cross-train with the Remote Patient Monitoring (RPM) billing processes.
• Provide backup coverage and overflow support for RPM billing when needed.
• Review RPM accounts for required information and documentation.
• Assist with RPM claim submission, corrections, denials, and follow-ups.
• Review RPM related claims for accuracy and assist with correcting rejected or denied claims.
• Support follow up on unpaid or denied RPM claims and assist with identifying recurring issues.
• Work with RPM team to resolve billing issues and discrepancies.

Team Support

• Assist with other billing and revenue cycle duties as needed.
• Help with workload and coverage during high-volume periods or staff absences.
• Learn additional billing functions to support the team.
• Identify reoccurring billing issues and help improve processes.
• Perform other duties as assigned.

Required Qualifications

• High school diploma or equivalent required.
• Previous experience in medical billing, insurance verification, revenue cycle, or a related healthcare role.
• Strong attention to details and accuracy.
• Excellent organizational and time management skills.
• Ability to manage multiple priorities and meet deadlines.
• Strong written and verbal communication skills.
• Ability to work independently and as part of a team.
• Experienced with electronic medical records, billing systems, and Microsoft Office applications.
• Ability to maintain patient confidentiality and follow HIPAA requirements.

Preferred Qualifications

• Medical billing experience in a physician or healthcare practice.
• Experience with Remote Patient Monitoring (RPM) billing.
• Knowledge of CPT/HCPCS codes and general medical billing practices.
• Experience with Medicare and commercial insurance.
• Experience with claim denials, rejections, and payer follow up.
• Willingness to learn additional billing functions and provide cross-coverage.
• Experience working in a high-volume, multiple provider healthcare environment.