Billing Specialist

• Coordinates and facilitates patient billing and collection activities
• Processes payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications
• Researches payments, denials, and accounts
• Builds strong working relationships with assigned business units

PFS Representative, CBO Billing, Follow-up, Denials Management

• Analyzes, designs, and implements efficient system of processing emergency department Point of Care Ultrasound (POCUS) coding and billing
• Serves as subject matter expert in emergency medicine coding and billing
• Manages quality assurance efforts to ensure accuracy and compliance
• Acts as liaison between emergency department and coding group leadership
• Develops educational sessions for compliance documentation and coding
• Produces regular reports with analysis of coding queues
• Acts as a knowledge resource for billing code issues

Emergency Medicine Billing Specialist

• Perform billing and accounts receivable functions by working collaboratively with Support Specialists, consulting staff, and other associates to support the enterprise’s initiatives.
• Assist with project management and train other associates.
• The Billing Operations Specialist is responsible for delivering timely and accurate client billing across the enterprise.
• This role supports accounts receivable, billing quality assurance, and invoice processing, while also providing secondary operational support for associates that may include, but is not limited to, travel and associate expense operations, scheduling, and client team support on various administrative client matters.
• Working closely with the Revenue Operations and Systems Manager, this position partners with Finance, HR, IT, consulting staff, and client teams to ensure billing accuracy, maintain policy compliance, and identify process improvements.
• The Specialist also contributes to documentation, training, and project management activities to enhance enterprise-wide financial operations.
• Conduct monthly billing QA reporting, including pre-bill adjustments, mark-ups, invoice consolidations, addition of value-added fees and data charges.
• Analyze client work in progress (WIP), prepare and format invoices, coordinate approvals and finalize or reinstate when needed.
• Work with consultants to modify invoice details, enter new clients and project codes, and maintain accuracy and compliance with contract specifications.
• Assist client teams with accurate capture and approval of billable time and expenses.
• Submit finalized invoices by auto e-bill or client-specific portals, ensuring write-offs are properly documented and approved.
• Monitor accounts receivable balances, aged receivables and WIP; resolve billing issues and client inquiries.
• Maintain accurate client billing information updating in coordination with associates and client teams.
• Serve as a subject matter expert on the enterprise’s billing process and related software.
• Continually identify and implement process improvements in billing, time tracking, and travel expense workflows in collaboration with Shared Services departments and business unit leaders.
• Process or serve as a backup for staff record updates (new hires, role changes, permissions) in coordination with HR.
• Help maintain system integrity and assist with upgrades, integrations, and administration of billing, timekeeping, and expense management platforms.
• Assist with project management activities in support of Finance and Operations initiatives, and support travel coordinators with expense submissions.
• Train associates and consulting staff on billing and expense procedures, systems, and best practices.
• Support administration of the organization’s T&E policy by reviewing and monitoring expense submissions and corporate card activity, ensuring compliance with IRS and internal guidelines, and escalating policy exceptions as needed.
• Contribute to internal communications, documentation, and knowledge sharing to ensure consistency across teams.
• Manage special projects, provide subject matter expertise, and train or mentor other billing support staff.
• Interact with department leaders, consultants, or other associates to troubleshoot complex issues.
• Reissue approved reinstated invoices when changes are required.
• Assist with creating and maintaining documentation of procedures regularly to ensure they are up to date and accurate.

Billing Operations Specialist

• Oversee all billing operations for Pain Management Practice
• Ensure accurate, compliant, and timely billing for clinic visits, interventional procedures, injections, diagnostics, and rehabilitation services
• Drive clean claim submission and optimal cash flow
• Manage billing for clinic visits, interventional pain procedures, injections, diagnostics, and rehabilitation services
• Ensure accurate charge entry, claim creation, and timely submission
• Serve as subject matter expert for pain management billing, fees schedules, liens, and direct bill processes
• Supervise billing staff, set productivity standards, and conduct performance reviews
• Partner with coding, authorization, AR, and clinical teams to resolve claim issues
• Monitor billing KPIs including clean claim rate, billing lag, and rejection trends
• Conduct audits and implement corrective action plans as needed

Billing Manager

• Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards
• Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers
• Reviews insurance denials and rejections to determine next appropriate action steps
• Updates and confirms necessary information to allow processing of claims to insurance plans
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement

Site Billing Specialist – CPC, CCS, RHIT or RHIA Certification

• Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.
• Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.
• Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
• Updates and confirms as necessary to allow processing of claims to insurance plans.
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
• Attaches referrals/authorizations to appointments/charges if available.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Makes and receives calls to/from patients to collect on self-pay balances and any other outstanding balance.
• Councils patients face to face when patients have questions or concerns regarding outstanding balances.
• Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.
• Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.
• Identifies and communicates trends and/or potential issues to management team.
• Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.
• Other duties as assigned by leadership.

Site Billing Specialist – CPC, CCS, RHIT, RHIA Certification

• Responsible for planning, directing, organizing, monitoring and staffing departmental services.
• Oversees and coordinates the insurance billing function, including claims submission, follow-up, and denial management.
• Supports staff in maintaining accuracy and timeliness in claims processing.
• Develops and implements quality assurance initiatives and monitors compliance with payer and policy requirements.
• Conducts regular audits and analyzes performance metrics.
• Partners with Revenue Cycle leadership on training and process improvement initiatives.

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