Patient Billing & Claims Specialist

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

Health benefits

Job summary

Cape Fear Valley Health System in Fayetteville, NC seeks a clerical professional to handle end-to-end patient account billing with third-party carriers, including claim submission, information gathering for adjudication, and responding to questions. The role supports accuracy and customer service across payer interactions.

The position requires 2 years of electronic billing or collections experience in a medical setting, strong English communication, and familiarity with CPT/ICD-10 codes.

Qualifications

• Education and Formal Training: High school diploma or equivalent required
• Work Experience: 2 years’ experience with electronic hospital billing or collections in a medical field required
• 1 year of experience with personal computer software and other office equipment required
• 1 year of medical terminology and familiarity with CPT-codes, ICD-10 codes and HCPCS codes preferred

Responsibilities

• Submits primary insurance claims to all carriers using the electronic claims terminal or send hard copy claims
• Uses the on-line work list and account referrals to review accounts that are pending payment from insurance companies for additional information
• Validates the accuracy of patient information so that future billing and follow-up activities are conducted effectively and to ensure a high degree of customer service.
• Applies adjustments and write-offs to accounts according to policy and procedure to assure accurate account balances and statements
• Maintains a suspense file of accounts that need additional documentation for eligibility determination prior to billing
• Receives incoming calls from patients and/or insurance companies concerning open accounts and answers questions and provides information in a courteous and cooperative manner to maintain good customer relations
• Other duties as assigned

Skills

Billing

Accounts receivable

Customer service

Electronic claims submission

Education

High school diploma or equivalent

Tools

UB-04 knowledge

Job description

Cape Fear Valley Health System in Fayetteville, NC seeks a clerical professional to handle end-to-end patient account billing with third-party carriers, including claim submission, information gathering for adjudication, and responding to questions. The role supports accuracy and customer service across payer interactions.

The position requires 2 years of electronic billing or collections experience in a medical setting, strong English communication, and familiarity with CPT/ICD-10 codes.