Billing Specialist

• Perform timely follow-up on outstanding insurance claims and unpaid accounts
• Investigate and resolve claim denials, rejections, and underpayments
• Post insurance and patient payments accurately and reconcile discrepancies
• Identify trends in denials or payment issues and escalate as needed
• Work aging reports and prioritize accounts based on timely filing and payer guidelines
• Communicate with insurance companies to obtain claim status, reprocess claims, or correct errors
• Submit corrected claims, appeals, and supporting documentation as needed
• Collaborate with coding and front-end teams to resolve billing issues at the source
• Maintain accurate account documentation and follow-up notes in the system

Billing Coordinator

• Conducts advanced data analysis, data validation, and reporting
• Ensures integrity of data flowing into the billing systems is accurate and complete
• Identifies, develops, documents, and implements process improvements within existing billing platforms and processes
• Assists in automating billing production files
• Participates in internal/external audit testing
• Runs reports through internal accounting system, Intacct, for analysis on accounts receivable
• Enters/uploads information into the billing system and calculates amounts due
• Prepares invoices, listing services provided and amounts due
• Prepares/processes credit memorandums on invoice to correct line items
• Posts transactions to accounting records such as worksheet, ledger or computer files
• Provides customer service to internal and external customers and may work closely with third party partners.
• Performs ad-hoc analysis and reporting for client specific inquiries

Billing Analyst II

• Communicate effectively to resolve discrepancies
• Process and maintain membership data
• Perform billing and accounts receivable activities
• Create and distribute membership materials

Enrollment and Billing Representative

• Answering high volume telephone calls
• Troubleshooting customer issues
• Speaking with customers in reference to abuse issues / policy violations
• Corresponding with customers in reference to service issues
• Answering Billing questions
• Corresponding with customers regarding updated credit card information
• Processing monthly refund and delinquent reports
• Helping to open and sort mail
• Posting payments and processing mail files
• Making courtesy calls to customers
• Auditing accounts
• Answering emails from department email box
• Communicating with partners in reference to accounts
• Working with other PTD departments to resolve customer issues
• Other duties as assigned by manager or director

Billing Clerk

• 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.

Patient Billing Representative

• Own the end-to-end billing process across subscription and usage-based revenue
• Ensure timely and accurate invoice generation
• Manage billing queue, prioritization, and execution
• Review and resolve complex billing scenarios (proration, expansions, terminations)
• Make real-time decisions to ensure billing continues moving forward
• Reduce dependency on manual review by standardizing workflows
• Manage AR team supporting billing and collections
• Ensure work is completed accurately and on time
• Provide guidance, prioritization, and accountability
• Partner with systems teams to improve automation and workflows
• Provide feedback on process gaps and inefficiencies
• Support adoption of new tools and processes
• Identify opportunities to simplify billing workflows
• Reduce manual effort through better process design
• Improve invoice quality and reduce customer inquiries
• Track and report on key billing metrics, including billing efficiency, cycle time, and accuracy

Billing Manager

• Processes, edits, audits and posts service entries into the EHR.
• Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
• Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
• Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
• Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
• Participates in the monthly closings and provides data and analysis for all payers.
• Communicates with the utilization review department regarding authorizations issues and inquires.
• Completes necessary processes for adjustments, write-offs, charity care and refunds.
• Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.
• Maintains interdepartmental reports for patient accounts and collections.
• Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
• Assists in the FY audits.
• Communicates with the Medical Records department for applicable data required for patient appeals and denials.
• Works on special projects as needed.
• Attends mandatory Gateway training and in-services.

• 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

• Under general supervision, responsible for enrollment and billing activities for the membership, enrollment & billing department.
• Performing membership and billing activities for clients and/or members.
• Duties include verifying enrollment status, making changes to records, addressing enrollment questions or concerns, resolving membership and billing issues, and accessing/updating enrollment and billing databases.
• Communicate effectively with internal and external contacts to promptly resolve discrepancies in membership and billing information and to promptly provide accurate responses to written, telephone and online inquiries.
• Process and maintain membership data.
• Manage multiple production oriented tasks and responsibilities.
• Perform various billing, accounts receivable, and reconciliation activities.
• Create and distribute membership/billing materials and communications to clients/members.
• Ensures acceptable service levels, metrics, and/or other performance guarantees are met.
• Conduct research to ensure issue resolution.
• Other duties as assigned or requested.

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