Billing Specialist

Position Summary:

The Billing Specialist is responsible for accurate and timely billing of services, including workers’ compensation, employer direct billing, and commercial insurance claims. This role ensures proper charge capture, claim submission, payment posting, and follow-up to support optimal reimbursement, compliance, and client satisfaction.

Primary Duties and Responsibilities:

 Prepare, review, and submit claims for occupational health services (workers’ compensation, employer direct, and commercial payers)

 Verify completeness and accuracy of charges, modifiers, and supporting documentation  Perform charge entry and review coding for accuracy (CPT, ICD-10) in collaboration with coding/clinical staff

 Monitor claim status and resolve rejections and denials in a timely manner

 Conduct follow-up with payers, employers, and patients to ensure payment

 Post payments, adjustments, and reconcile accounts as needed

 Maintain accurate patient and employer account information

 Identify trends in denials and billing issues; escalate as appropriate

 Ensure compliance with payer requirements, HIPAA, and regulatory standards

 Communicate with front office and clinical teams to resolve documentation or registration issues

 Support employer client billing requirements, including invoicing and reporting when applicable

 Maintain productivity and quality standards

 Participate in interdisciplinary case reviews and care coordination

Team Member Objectives:

 Achieve timely and accurate claim submission and payment posting

 Reduce claim denials and improve first-pass resolution rates

 Maintain accurate and compliant billing documentation 73

 Support positive patient and employer billing experience

 Contribute to overall revenue cycle efficiency and financial performance

 Demonstrate accountability, teamwork, and continuous improvement

Key Competencies

 Knowledge of medical billing and reimbursement processes

 Attention to detail and accuracy

 Analytical and problem-solving skills

 Time management and ability to meet deadlines  Effective communication skills

 Customer Service orientation

 Familiarity with occupational health billing (workers’ compensation, employer services) preferred

Qualifications, Education, and Experience

 High school diploma or equivalent required

 Minimum of 2–4 years of medical billing experience

 Certification (e.g., CPC, CPB) preferred

 Experience in occupational medicine, urgent care, or multi-payer environments preferred  Experience with medical billing, claims processing, and denial management

 Proficiency in EHR and practice management systems

 Understanding of payer guidelines and reimbursement methodologies

 Knowledge of HIPAA and compliance standards

Pay: $24.00 - $27.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid sick time
• Paid time off

Work Location: In person