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Why You’ll Love This Job

General Description: 
The Insurance Verification & Billing Specialist manages all insurance verification, coding and charge capture, and oversight of the third-party billing on behalf of a busy primary care practice.  This role is responsible to ensure accuracy and timeliness in all aspects of the revenue cycle management process.  

Job Duties and Responsibilities

Specific Responsibilities of the Job: 

  • Conduct insurance verification, eligibility and benefits before each medical visit and ensures all prior authorization is complete prior to delivery of ambulatory practice services.  
  • Lead, evaluate and maintain processes and workflow to ensure efficient and accurate billing and collections.  
  • Confirms billed services are accurate and complete prior to submission to billing service or clearing house.  
  • Post and track receipts from patients and insurers.  
  • Serve as primary liaison to third-party billing service, including oversight of billed charges, denials and appeals, payments and postings.  
  • Monitor billing software dashboards and review account receivables with clinic, financial and senior leaders.  
  • Works effectively with clinic and office manager, providers and clinic staff, third party billing service, and finance and accounting to coordinate billing and collection activities.  
  • Assists in retrieving provider encounter notes to support billing/ charges, when needed.  
  • Assists patients in understanding insurance benefits and patient financial responsibilities prior to services being rendered.  
  • Ensure workflow and standard operating procedures are documented and maintained.  
  • Work with clinic leadership to identify areas of improvement in the insurance verification, billing, and collection processes.  
  • Strong team player that thrives in a fast-paced, busy primary care practice.  
  • Model the highest level of service and professionalism for both internal and external customers. 
  • Other duties, as assigned. 


Required Knowledge, Skills and Abilities: 
Job Requirements: 

  • Demonstrated experience in ambulatory practice insurance verification and billing.  
  • Demonstrated ability to handle multiple responsibilities to meet tight deadlines in a complex environment. 
  • Demonstrated knowledge of physician reimbursement, medical terminology, ICD-10, CPT and HCPCS coding.   
  • Proficiency in MS Word, Excel and Outlook.  Experience with MS Teams preferred.  
  • Excellent written and oral communication skills. 
  • Excellent technical and business acumen.  

Education and Experience: 

  • High School Diploma required. Some college education preferred 
  • 5 years of experience in insurance verification and billing in a comprehensive and specialty care environment. Experience working with third-party billing service preferred.  
  • Certification in coding and billing preferred. 

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Type: Full Time (Hourly)
Job ID: 87836