Senior Patient Billing & Compliance Specialist

PathGroup; Coppell (TX); On-site; USD 46,000 - 66,000; Full time

Job summary

PathGroup in Coppell, TX, is seeking a Patient Billing Representative to serve as a subject matter expert for patient billing inquiries, escalations, and issue resolution. This role focuses on delivering a positive patient experience while ensuring compliance with billing policies.

The ideal candidate will have 5+ years in customer service and healthcare billing, strong knowledge of EOBs, HIPAA, and insurance claim processing, and the ability to work independently as well as within a team.

Qualifications

• 5+ years of customer service and billing experience, preferably in healthcare.
• Understanding of Explanation of Benefits and patient billing workflows.
• Strong understanding of insurance claim processing to resolve patient billing inquiries.
• Excellent oral and written communication skills.
• Knowledge of HIPAA compliance.
• Proficiency with billing software and MS Office.
• Ability to work independently and collaboratively.
• Familiarity with Corporate Compliance Program and Privacy/Security policies.

Responsibilities

• Research escalated patient billing inquiries and resolve with internal/external resources.
• Monitor BBB inquiries and coordinate responses with management.
• Audit patient billing processes for accuracy and completeness.
• Identify trends in patient inquiries and suggest process improvements.
• Support the department in meeting call handling, patient satisfaction, and resolution goals.
• Triage inquiries via email or tracking system for timely resolutions.
• Provide courteous, professional service to patients and stakeholders.
• Handle other related duties or special projects as assigned.
• Adhere to security and regulatory guidelines to protect PHI.
• Follow Corporate Compliance Program and Corporate policies.

Skills

Customer service

Billing

Communication skills

HIPAA compliance

Problem-solving

Independence & collaboration

Education

High School Diploma or GED

Tools

Billing software

MS Office

Job description

PathGroup in Coppell, TX, is seeking a Patient Billing Representative to serve as a subject matter expert for patient billing inquiries, escalations, and issue resolution. This role focuses on delivering a positive patient experience while ensuring compliance with billing policies.

The ideal candidate will have 5+ years in customer service and healthcare billing, strong knowledge of EOBs, HIPAA, and insurance claim processing, and the ability to work independently as well as within a team.