Staff members from Prism health North Texas Oak Cliff Health Center Clinic

Billing Specialist JobDallas, TX

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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.  


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. 

Skills & Qualifications

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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