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Billing Specialist Job Description

Job Title: Billing Specialist

Location: Ironton

Reports To: Fiscal Team Lead

Position Summary: The Billing Specialist is responsible for the accurate and timely processing of insurance claims, client billing, payment posting, and account reconciliation to support the organization's revenue cycle. This position works closely with clinical, administrative, and finance staff to ensure billing compliance with payer requirements, organizational policies, and applicable state and federal regulations. The Billing Specialist assists in resolving billing discrepancies, following up on outstanding claims, and maintaining the confidentiality of all clients financial and health information while providing excellent customer service.

Mission Statement: We strive to provide Trauma Responsive Care across all communities we have the privilege to serve, promoting overall mental, physical, and spiritual wellness.

Job Duties:

• Adhere to TPC Wellness Mission Statement
• Manage failed activities
• Manage self-pay claims
• Manage overlapping report
• Manage and submit PA’s and conduct follow-up
• Manage failed claims
• Help fix billing errors
• Coordinate peer-to-peer reviews for clients/insurance companies
• Help manage contracts with insurance companies
• Assist with credentialing process
• Assist with working denials
• Help maintain weekly and monthly financial reports
• Create and submit billing batches
• Efficiently operate personal computer to enter, edit and/ or retrieve data to produce reports and documentation
• Effectively work as a team member including participating in all required trainings

Minimum Qualifications:

• 2-3 years of experience with EHR system in billing and healthcare

Education Requirements:

• High School Diploma
• Associate’s degree preferred

Skills Required:

• Organization
• Time Management
• Technology Skills
• Strong attention to detail and follow-up skills

All job requirements indicate the minimum level of knowledge, skills, and/or ability as deemed necessary to perform the job proficiently. This job description is not to be construed as an exhaustive statement list of duties, responsibilities, or requirements. Employees may be required to perform any other job- related tasks as required by their supervisor, subject to reasonable accommodation.

The TPC Wellness is an Equal Opportunity Employer; applicants will receive consideration for employment without regard to race, religion, color, sex, sexual orientation, and national origin, disability, age or Vietnam-era status. All the above duties and responsibilities are essential job functions subject to reasonable accommodation.

All job requirements listed indicate the minimum level of knowledge, skills, and/or ability as deemed necessary to perform the job proficiently. This job description is not to be construed as an exhaustive statement list of duties, responsibilities, or requirements. Employees may be required to perform any other job-related tasks as required by their supervisor, subject to reasonable accommodation.