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

• Support patients with payment processing, billing education, insurance verification, and claims-related inquiries.
• Deliver empathetic, accurate, and compliant service while navigating healthcare billing systems and policies.
• Perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.

Patient Billing Representative

• Supports the complete and timely collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into the billing system.
• Tracks all high dollar claims from charge entry to payment and resolves complex carrier issues.
• Actively follows up on outstanding complex claims/or charges.
• Reviews and resolves complex issues that result in payer denials, including appeals, coding corrections, medically necessity rules and other related functions.
• Assists the auditor in reviewing notes for medical necessity.
• Works with the authorization department to resolve authorization issues with complex procedures.
• Runs and maintains tracking logs to track complex high dollar procedures and report the results to the billing department management team.
• Contacts the various Provider Service Representatives to resolve repetitive payment issues.
• Acts as a resource for the Billing Staff for complex issues.
• Analyzes and resolves billing issues, keeping A/R to no more than 10% over 60 days.
• Processes daily correspondence, claim status, handle denials, appeals and re-bills.
• Answers billing questions and inquiries from patients and internal staff.
• Updates patient files with address changes, contact information changes, etc., as needed.
• Reviews all policy changes on a regular basis and informs supervisor and charge entry specialist of such changes.
• Efficiently navigates assigned insurance companies' proprietary websites to find policies, research payments, etc.
• Keeps supervisor apprised of matters regarding accounts receivable.
• Responds to requests from billing company in a timely fashion.
• Researches denials and submits correct claims/medical documentation.
• Reviews and manages claims within the work dashboard hold buckets for resolution.
• Creates, maintains and updates reports, as directed.
• Exercises confidentiality in all areas, abiding by HIPAA rules and regulations.
• Helps train new revenue cycle staff.
• Collects and reviews end of day reports.
• Checks work e-mail on a regular basis throughout the workday.
• Participates in and completes all required trainings and in-services.
• Performs other duties as assigned.

Billing Specialist II

• Provide Epic product function, design, and build expertise and experience needed for successful product implementation.
• Serve as the primary resource dedicated to application design, validation, and build within assigned area.
• Assess current state, design and implement future-state workflows by interacting with department representatives to analyze business/operational needs, and translate these into proper system configuration.
• Provide demonstration of system functionality; create and submit regular status reports to immediate Lead Analyst/Project Manager/IT Leadership as assigned.
• Coordinate/facilitate organizational meetings and attend weekly team meetings to discuss team and project related activities, issues, changes, communications, and updates.
• Develop, support, and maintain documentation and procedures as needed and provide training to other IT staff and user clients as appropriate.
• Troubleshoot problems identified by team members and end-users, analyze and coordinate system changes, and implement approved changes based on customer-designated priorities.
• Review and test build and new releases/enhancements prior to implementing in the production environment, and maintain established guidelines related to build standards and Change Control processes.
• Collaborate with Principal Trainers in the design and development of role-based training programs to support the workflows to be implemented, and assist with training of end-users on proper use of the system.
• Contribute to preparation of testing scripts, perform unit/system/integrated testing tasks in a structured manner, and appropriately document test results.
• Provide expertise and experience to the development of activation plans, application activation tasks, and production environment readiness.
• Provide on-site support as needed during Go-live/Downtime events.

Senior Analyst – Epic Hospital Billing

• 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.

Billing Specialist jobs in South Carolina

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

Patient Billing Representative

Billing Specialist II

Senior Analyst – Epic Hospital Billing

Insurance Billing Supervisor – Full Time, Day Shift