Patient Billing & Insurance Specialist

Springfield Clinic; Jacksonville (IL); On-site; USD 38,000 - 46,000; Full time

Job summary

Springfield Clinic is seeking a Patient Service Representative - Operations to discuss insurance coverage, verify benefits, and explain billing policies. The role involves coordinating with insurance carriers, validating referrals, and ensuring timely payments while delivering excellent customer service.

You will handle prior-authorization processes, oversee denials and collections, and assist providers and staff with billing inquiries.

Qualifications

• High School graduate or GED required.
• Minimum two to three (2-3) years experience in medical billing and insurance preferred.
• Ability to handle multiple tasks and prioritize in a fast-paced environment.
• Strong verbal communication and listening skills are required.
• Knowledge of Medicare, medical assistance and other third party payors.
• Empathetic, yet responsive to Patient Accounting billing policies and guidelines.

Responsibilities

• Verify/secure referrals.
• Verify coverage and benefits prior to treatment.
• Secure prior-approval and pre-authorizations.
• Perform review and action of Bad Debt, Collections, and Denials.
• Maintain proficiency with insurance and billing issues and serve as a resource to providers and staff.
• Prepare account action worksheets and submit to Patient Accounting for charge corrections.
• Provide a positive impression to patients about the Clinic's billing department.
• Enter/edit patient insurance coverage/demographic information when necessary.
• Inform patients of the Clinic's billing and credit policies.
• Answer questions that patients may have in regard to insurance coverage and other billing issues.
• Respond to patient's verbal and written requests in a timely fashion.
• Maintain statistics.
• Maintain proficiency with insurance and billing issues by participating in Patient Accounting meetings and training sessions as appropriate.
• Must be empathetic, yet responsive to patients while adhering to Patient Accounting billing practices and guidelines.
• Provide coverage at other Springfield Clinic locations as assigned.
• Comply with the Springfield Clinic incident reporting policy and procedures.
• Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
• Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
• Perform other job duties as assigned.

Education

High School graduate or GED required

Job description

Springfield Clinic is seeking a Patient Service Representative - Operations to discuss insurance coverage, verify benefits, and explain billing policies. The role involves coordinating with insurance carriers, validating referrals, and ensuring timely payments while delivering excellent customer service.

You will handle prior-authorization processes, oversee denials and collections, and assist providers and staff with billing inquiries.