Senior Clinical Billing Specialist in United States at Jobgether
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Job Description
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Clinical Billing Specialist based in the United States.
This role is a key expert position within healthcare revenue cycle operations, focused on resolving complex patient and provider billing issues with accuracy and efficiency.
You will investigate, analyze, and resolve physician and hospital accounts while ensuring compliance with billing regulations and patient confidentiality standards.
The position requires strong analytical thinking to identify root causes of claim denials and implement corrective actions.
You will work closely with patients, providers, insurers, and internal departments to ensure accurate claim processing and timely resolution of accounts.
This is a detail-oriented, high-responsibility role requiring strong communication and problem-solving skills in a regulated healthcare environment.
You will also contribute to process improvements and support best practices in billing and revenue cycle management.
The role is remote after initial onsite training and requires a secure, confidential work setup.
- Investigate and resolve complex physician and hospital account balances, identifying causes of non-payment and initiating claim corrections or resubmissions.
- Analyze denied claims, determine root causes, and prepare appeals within required timelines to prevent write-offs.
- Develop and submit appeal letters, gather supporting documentation, and ensure proper follow-up with payers.
- Perform cash reconciliation and ensure accuracy of financial and billing records.
- Assist patients with billing inquiries, insurance questions, and account clarifications via phone and electronic communication.
- Update patient and insurance information, verify coverage details, and ensure accurate claim submission and resubmission.
- Post payments, manage payment plans, and complete end-of-day processing activities.
- Support collections processes and coordination with external agencies to ensure continuity of revenue recovery.
- Interpret contract documents and apply billing guidelines accurately in account resolution.
- Prepare reports, analyses, and documentation to support operational decision-making and process improvements.
- Ensure compliance with HIPAA regulations, confidentiality standards, and organizational billing policies.
- Collaborate with internal departments to improve billing workflows and resolve systemic issues.
- High school diploma or GED with 5+ years of healthcare revenue cycle or bookkeeping experience; OR
- Associate’s degree with 3+ years of relevant healthcare billing or revenue cycle experience; OR
- Bachelor’s degree with 1+ year of healthcare revenue cycle experience or equivalent combination of education and experience.
- Strong understanding of medical billing processes, insurance claims, and revenue cycle operations.
- Experience with healthcare billing systems (EPIC preferred) and claims management tools.
- Knowledge of insurance policies, denial management, and appeals processes.
- Strong analytical and problem-solving skills with attention to detail and accuracy.
- Excellent verbal and written communication skills with the ability to interact professionally with patients and stakeholders.
- Basic mathematical skills and ability to manage financial data accurately.
- Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment.
- Solid understanding of HIPAA compliance and patient confidentiality requirements.
- Hourly compensation of $18.99/hr.
- Comprehensive benefits eligibility including medical, dental, and vision coverage.
- Paid time off including vacation, holidays, and sick leave.
- Retirement benefits with employer contribution matching options.
- Employee training and career development opportunities in healthcare administration.
- Education discounts for employees and eligible dependents.
- Supportive work environment focused on patient care, accuracy, and professional growth.
- Remote work eligibility after completion of onsite training, with required secure home office setup.