Billing Specialist

• Join us as a Patient Billing Specialist, where you’ll support patients with payment processing, billing education, insurance verification, and claims-related inquiries.
• This role delivers empathetic, accurate, and compliant service while navigating healthcare billing systems and policies.
• Agents perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.
• Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
• Create, update, and maintain payment plans following established guidelines.
• Ensure transaction accuracy, proper documentation, and data integrity.
• Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
• Verify, audit, and update insurance information for completeness and accuracy.
• Add or update insurance data within the EMR and resubmit pending or corrected claims.
• Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
• Identify discrepancies and coordinate with internal teams to resolve billing-related issues.
• Research account history to determine the root cause of billing or payment concerns.
• Recommend appropriate resolutions and next steps in alignment with Privia policies.
• Maintain professionalism and empathy during complex or sensitive financial discussions.
• Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
• Navigate multiple systems simultaneously while assisting patients.
• Adhere to all documentation, privacy, and security requirements.
• Maintain schedule adherence and consistent availability during assigned hours.
• Complete all required Privia and client-mandated training.
• Participate in ongoing uptraining and cross-training initiatives.
• Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.

Patient Billing Representative

• Ensure strict HIPAA-compliant confidentiality with all client data and claims
• Manage and operate in multiple different billing platforms dependent on client needs which could include Azalea, Tebra, Central Reach and/or Rethink Integrated Billing Module
• Manage assigned client accounts billing scrubs for primary and secondary claims
• Submit claims electronically for primary and secondary payors
• Solve clearinghouse rejections
• Submit corrected claims for billing errors, rebill projects (new plans/new year, new information on payor policies)
• Maintain account spreadsheets, billing cheat sheets, provider, and billing information including provider roster and payer policy billing rules
• Contribute to updates and communicate to Customer Billing Advocate and other members of POD
• Provide internal reporting to team of status and issues for clients within POD
• Meet internal benchmarks for clean claims / first pass rate, unbilled claims, clearinghouse rejections, secondary claims, and denials for billing errors
• Research specific payor billing rules as needed
• Review client billing documentation to ensure claims are submitted based on payor requirements
• Stay informed about Payor and Industry Billing rules
• Foster a positive work environment for team members

• Prepare, review, and process standard customer invoices in accordance with established procedures.
• Manage dropship customer billing, ensuring accurate documentation and timely invoices.
• Handle project-based billing, tracking milestones and deliverables for correct charge allocation.
• Upload and process invoices through customer portals, ensuring compliance with client-specific requirements.
• Process vendor dropship bills in Stampli—including coding and approving for payment—after processing order fulfillment and billing in NetSuite, ensuring proper period alignment between related documents.
• Serve as a primary point of contact for customer billing inquiries, providing clear, timely, and professional communication.
• Build and maintain positive customer relationships by addressing concerns, resolving discrepancies, and ensuring a smooth billing experience.
• Collaborate with sales, operations, logistics, procurement, and project management teams to gather necessary billing information and resolve issues.
• Maintain accurate billing records and documentation for audit and reporting purposes.
• Identify and recommend process improvements to enhance billing efficiency, accuracy, and customer satisfaction

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