Billing Specialist — Invoicing & Insurance Claims

# Billing Specialist – Invoicing & Insurance Claims ## Position Overview We are seeking a highly organized, detail-oriented **Billing Specialist – Invoicing & Insurance Claims** to serve as the lead specialist for all billing, invoicing, insurance claims, and financial operations within our growing healthcare practice. This individual will be the primary point of contact for insurance companies, patients, providers, and staff regarding billing, claims processing, reimbursement, and insurance-related questions. The ideal candidate will have experience in medical billing and insurance claims management, be comfortable working independently, and possess a strong understanding of insurance benefits, reimbursement processes, and accounts receivable management. This role is critical to ensuring accurate billing, timely payments, and the overall financial health of the practice. ## Responsibilities ### Insurance Claims Management * Submit, track, and manage insurance claims through electronic clearinghouses. * Monitor claim status and follow up on unpaid, denied, rejected, or underpaid claims. * Investigate and resolve claim denials, billing discrepancies, and reimbursement issues. * Verify insurance eligibility and benefits as needed. * Maintain current knowledge of payer policies, billing requirements, and reimbursement guidelines. ### Billing & Invoicing * Prepare, generate, and submit patient and organizational invoices accurately and timely. * Process insurance claims and ensure proper documentation and coding. * Monitor and manage outstanding balances, accounts receivable, and collections. * Reconcile insurance and patient payments and maintain accurate financial records. * Work with patients regarding billing questions, balances, payment arrangements, and invoice collection. ### Insurance & Financial Expertise * Serve as the practice's primary resource for insurance and billing-related matters. * Demonstrate knowledge of: * Deductibles * Copayments * Coinsurance * Out-of-pocket maximums * Explanation of Benefits (EOBs) * Prior authorizations * Coordination of Benefits (COB) * Claims appeals and denial management * Assist with improving billing workflows, reimbursement processes, and collections procedures. ### Communication & Collaboration * Act as the primary liaison between the practice, insurance carriers, providers, patients, and staff. * Communicate professionally and effectively with insurance representatives to resolve claim and payment issues. * Collaborate with clinical and administrative teams to ensure accurate documentation and billing practices. * Maintain HIPAA compliance and patient confidentiality at all times. ## Qualifications ### Required * Minimum of 2 years of experience in medical billing, insurance claims processing, or healthcare revenue cycle management. * Experience submitting and managing claims through electronic clearinghouses. * Strong understanding of medical billing, insurance reimbursement, and collections processes. * Knowledge of deductibles, copays, coinsurance, EOBs, claim denials, and insurance verification. * Experience preparing invoices, processing payments, and managing accounts receivable. * Ability to work independently and manage multiple priorities. * Strong attention to detail, organizational skills, and problem-solving abilities. * Excellent verbal and written communication skills. ### Preferred * Experience in behavioral health, mental health, or private practice settings. * Familiarity with commercial insurance plans, Medicare, and Medicaid. * Experience handling appeals, denials, and payer audits. * Proficiency with EHR, billing, and practice management software. ## What We're Looking For We are looking for someone who takes ownership of the billing process, enjoys solving problems, and can confidently navigate insurance and financial matters on behalf of the practice. The ideal candidate is proactive, dependable, and committed to ensuring claims, invoices, and payments are handled accurately and efficiently while providing excellent service to both patients and providers.