Billing Specialist

• Submit billing claims that are timely and accurate with correct CPT/ICD10 codes, modifiers, units and amounts.
• Resolve rejections/denials on a routine and timely basis
• Post and reconcile payments
• Monitor and follow up on outstanding AR
• Collaborate with the Clinical Team to ensure accurate coding
• Communicate with Clinical Supervisors regarding documentation and coding clarification
• Ensure compliance with payer guidelines, Medicaid and HIPAA regulations
• Use the finance accounting software to track receivables
• Act as a liaison between the Finance Department the Clinical team
• Maintain a collection rate of at least 80%
• Provide monthly billing report updates to Executive Team
• Upload DARTS admissions and discharges
• Bill DARTS accurately and timely

Medicaid Billing Specialist

• Collaborate with global and domestic cross-functional teams to resolve patient questions, concerns, and issues related to Medicare coverage, claims, denials, and patient responsibility
• Handle high-volume inbound and outbound calls related to Medicare billing statements, coverage, payment plans, and coordination of benefits (COB)
• Accurately document all patient interactions, including inquiries, complaints, and resolutions, ensuring compliance with Medicare and internal documentation standards
• Interpret EOBs and explain Medicare patient responsibility, coverage limitations, and claim outcomes
• Verify insurance eligibility, benefits, and coverage through payer portals, with a focus on Medicare qualification and active coverage
• Review and recalculate invoices as needed to ensure alignment with Medicare billing rules and reimbursement guidelines
• Manage and resolve denials and appeals, ensuring proper documentation and adherence to Medicare requirements for medical necessity and claims processing including Medicare audits
• Request and validate clinical documentation, prescriptions, and supporting records required to meet Medicare medical necessity standards
• Coordinate with internal teams to ensure claims are clean, accurate, and ready for submission or resubmission
• Respond to patient communications across multiple channels, including phone, email, portal, and fax
• Route complex issues to appropriate teams while maintaining ownership of resolution
• Ensure adherence to HIPAA, confidentiality, and Medicare compliance requirements at all times
• Follow up on open tasks, worklists, and outstanding issues in a timely manner
• Support equipment recovery processes when treatment ends or Medicare benefits terminate
• Maintain knowledge of Medicare billing, reimbursement guidelines, and DMEPOS requirements

Medicare Specialist – Medicare Billing

• Review customer contracts and correspondence, interpreting ambiguous contract language to determine correct billing treatment
• Process invoices and credit memos for complex or non-standard billing scenarios
• Guide and support teammates on invoice processing workflows within Zone
• Review invoices processed by the team for accuracy before sending out to customers
• Respond to customer billing inquiries via email, researching and providing accurate answers in a timely manner
• Perform daily cash application: match incoming customer payments to invoices and post accordingly
• Own follow-up on past-due accounts, coordinating escalations with Fund Admin/CX as needed
• Monitor AR aging and flag at-risk balances to the Billing & Collections Manager
• Play a key role in ongoing process improvements and workflow refinement within Zone (project-based work)
• Manage increased workload during peak Fund Admin billing cycles (December, March, June, September)
• Partner cross-functionally with Deal Desk on contract structuring, and with Fund Admin/CX on billing and collections
• Comfortable using AI tools to improve productivity and efficiency across billing, cash application, and reporting workflows

Senior Billing & Collection Specialist

• Own the product strategy, roadmap, and delivery outcomes for the Core Billing, Invoicing, and Statements Platform, including core billing engines, dynamic document rendering, statement distribution APIs, and preference management tools.
• Define and maintain the billing and statements roadmap across Ford Credit initiatives, Ford Pro, the Ford Credit digital teams, Agent Servicing, downstream financial accounting systems, and external print vendors.
• Translate complex business rules, modern lending platform capabilities, legacy system migrations, and technical requirements into clear product backlogs, MVP definitions, and execution plans.
• Partner with peer teams to define invoicing MVP boundaries, supporting complex commercial fleet consolidated billing, account hierarchies and grouping structures, and custom billing templates.
• Lead product definition for complex billing scenarios, including statement cycle logic, grace period calculations, dynamic fee and amortization displays, interest accrual presentation, late fee application rules, and billing correction/reversal flows.
• Lead requirements for state-of-the-art document composition technologies, focusing on dynamic localized translations, ADA accessibility compliance (Web Content Accessibility Guidelines), and print/digital layout consistency.
• Define and prioritize billing control requirements, such as invoice validation runs, statement generation reconciliation, duplicate billing checks, out-of-balance processing holds, and secure audit logging for compliance.
• Represent Billing and Statements in PI planning, QBRs, executive readouts, architecture reviews, and risk/compliance escalation discussions.
• Partner with engineering leadership to ensure system designs are scalable, resilient, appropriately sequenced, and aligned to team capacity.
• Identify and escalate risks related to billing accuracy, regulatory disclosure errors (e.g., Truth in Lending Act, Regulation Z, Regulation E), print vendor processing delays, and production readiness.
• Define product success metrics and operational health indicators, including statement generation SLA adherence, paperless adoption rate, delivery failure rates, system latency for real-time document retrieval, and billing dispute trends.

Group Product Manager – Billing Modernization

• Monitor, process, report and document a variety of transactions including but not limited to suspense, adjustments, premium receipt, invoicing, deduction requests, reversals, reposts and delinquencies
• Coordinate with other business areas to ensure accurate premium processing, reporting, billing and fee disclosure
• Perform research as needed in support of reconciliations and adjustments
• Prepare and create monthly bills for alternately billed groups
• Act as a resource for external and internal business areas on process, procedure and systems
• Implement billing and delinquency operations to maximize effectiveness and accuracy
• Audit the accuracy of billing and delinquency information entered in the system and monitor operation of the billing system
• Develop solutions to billing and delinquency issues and work with systems design to implement system and process enhancements
• Work on special projects with management
• Proactively communicate sensitive and /or confidential policy and billing information, as well as providing solutions in a clear and effective manner to policyholders, producers, third party administrators, field force and home office staff based on Generally Accepted Accounting Principles (GAAP), federal regulations, contractual provisions and other related policy information

Billing Clerk

• Perform individual administrative functions for clients including enrollment and billing
• Gather and analyze client requirements and recommend solutions
• Install and maintain clients in billing system
• Support open enrollment by providing member details
• Process enrollments and troubleshoot issues
• Monitor reports to validate client information

Enrollment & Billing Administrator

• Responsible for all aspects of invoice submissions via various e-billing platforms
• Resolving e-billing issues for the law firm's e-billed clients
• Work directly with the client’s E-billing Manager on any ad-hoc e-bill related management/client requests
• Submission of electronic invoices and accruals to clients on monthly basis
• Overseeing the transition of clients to e-billing
• Providing follow-up support to attorneys, and clients in all aspects related to electronic billing
• Handle heavy volume of highly complex e-submission assignments for key corporate clients
• Act as liaison between billing attorney/secretarial staff, and clients' staff assigned to electronic billing
• Liaise with billing attorney/secretary, and client representatives in the resubmission of invoices
• Populate, maintain, and update data for assigned clients in the billing system

eBilling Analyst

• Manage daily services billing operations, including time & materials, fixed fee, and recurring billing
• Actively participate in billing activities, including invoice review, adjustments, and issue resolution
• Support mid-month and month-end billing cycles to ensure timely and accurate invoice generation
• Review invoices, credits, and adjustments for accuracy and alignment with contracts
• Lead and support a small team of billing specialists, including workload management and coaching
• Help ensure team adherence to billing timelines and internal SLAs
• Serve as a point of escalation for billing questions and issues
• Partner with Project Managers and Operations to resolve billing discrepancies and ensure alignment with project activity
• Monitor time entry and approval status, following up as needed to support timely billing
• Provide visibility into unbilled activity and open items impacting billing
• Assist with monthly reviews of billed and unbilled activity
• Support investigation of variances between billing data and financial reporting
• Partner with Finance to provide detail and context on billing-related items as needed
• Identify opportunities to improve billing processes and reduce manual effort
• Support PSA/ERP systems (e.g., Changepoint, Intacct) related to billing activities
• Help ensure consistency and accuracy in billing workflows and documentation

Billing Operations Supervisor

• Prepare and manage weekly billing activities and invoice submissions.
• Prepare and re-submit corrected claims or invoices as needed.
• Bill payers by inputting billing information into databases.
• Appeal denied claims utilizing clearinghouse or payer portal functionality.
• Reconcile billing activities between clearinghouse and host systems.
• Reconcile payments and perform denial research using database queries and spreadsheet analysis.
• Verify and maintain accurate receivable balances across multiple information systems.
• Prepare reports based on Medicaid billing data and revenue.
• Adjust patient bills by reviewing remittance advice and consulting with management.
• Resolve billing discrepancies by conducting research and correcting errors.
• Perform minimal business-to-business collection activity to maintain low and current receivable balances.
• Follow up on delinquent payer remittances and payments.
• Escalate emerging denial trends and determine root cause analyses.

Medicaid Billing Clerk

• Responsible for the strategic administration and oversight of benefit billing operations
• Analyze complex billing, eligibility, and financial reconciliation issues
• Lead routine and ad hoc audits; identify operational and financial risks
• Establish and maintain effective internal controls; ensure accuracy of financial transactions
• Collaborate with internal leadership, trustees, vendors, auditors, and legal counsel
• Develop standardized audit procedures and reconciliation methodologies
• Investigate discrepancies, determine root cause, and implement corrective actions
• Respond to employee inquiries regarding benefits eligibility, plan provisions, claims and coverage issues

Benefits Billing/Operations Analyst

• Train various agency staff in the revenue cycle including billing, collecting, and recording revenue transactions
• Support the accounts receivable functions under the supervision of the Revenue Cycle Manager
• Enhance the agencies’ policies and procedures surrounding the revenue and accounts receivable cycles
• Monitor internal controls to assure compliance with established procedures
• Partner with AR Market Leaders with monitoring accounts receivables and developing action plans
• Train staff on software systems and processes
• Manage time equally between service center projects and field support
• Lead and manage a team of AR Resources

AR Lead – Billing and Collections

• Review DME billing for accuracy, compliance, and alignment with payer guidelines.
• Verify and correct HCPCS codes, quantities, chart notes, and supporting documentation.
• Adjudicate claims and follow up on unpaid claims, rejections, and denials through resolution.
• Use billing systems including Frameworks LTC, ECM, and Medbill to process and manage DME claims.
• Communicate with pharmacists, technicians, medical professionals, insurance companies, and pharmacy teams across multiple locations.
• Identify billing issues, recommend corrections, and help improve claim accuracy and workflow efficiency.
• Perform other related duties as assigned.

DME Pharmacy Billing Specialist

• Ensure the billing process is completed accurately, timely, and efficiently.
• Daily processing of claims and reviewing remittance advice forms.
• Answer billing questions from internal and external customers.
• Document communication in EMR system.
• Run billing reports and file disputes as necessary.
• Upload and log electronic remits from various insurance companies.
• Follow-up with insurance companies and payment guarantors.
• Monitor collection/aging worksheets and manage accounts.
• Participate in weekly billing team meetings and report payer trends.
• Attend community involvement events and perform additional projects as assigned.

• Process and manage billing for assigned accounts and/or entities
• Ensure invoices are accurate, complete, and submitted in a timely manner
• Maintain billing records and documentation for all assigned work
• Coordinate with operations and account management to confirm work completion status prior to invoicing
• Review work order documentation, photos, and closeout records to validate billing accuracy
• Identify and resolve any gaps or discrepancies between completed work and billing records
• Apply accurate pricing to completed work orders in applicable systems (Salesforce, OfficeTrax, and/or client portals)
• Process pricing updates and invoice entries as assigned, including specialty trade pricing where applicable
• Coordinate with account coordinators on closeout pricing tasks to ensure consistent billing flow
• Identify and proactively resolve billing discrepancies, disputes, or submission errors
• Escalate unresolved billing issues to the appropriate account or operations team member
• Support revenue reporting and reconciliation for assigned accounts and entities
• Maintain organized records to support financial reviews and audits

Billing Coordinator

• Provide accurate billing information to deliver sustainable, mission-driven services.
• Manage the Electronic Visit Verification (EVV) system for Community-Based Services.
• Run and reconcile bi-weekly EVV reports.
• Review, document, and correct inaccurate EVV entries.
• Manage CBS staff schedules within the EVV system.
• Collaborate with program supervisors and staff to resolve scheduling or EVV-related issues.
• Maintain current knowledge of Federal, State, and Office of Developmental Programs (ODP) EVV regulations and requirements.
• Access, maintain, and distribute Individual Support Plans (ISPs) from HCSIS.
• Assist with data entry related to Virtual Program billing and Meaningful Day CPS billing.
• Enroll new admissions into EVOLV.
• Complete special projects, assignments, and additional duties as assigned.

Program Billing Coordinator – Community Based, Virtual Services

• 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

• Claim Lifecycle Management: Prepare, review, and submit clean claims daily through Open Dental to ensure rapid reimbursement.
• Insurance Verification & Breakdown: Obtain detailed, accurate insurance breakdowns and input them cleanly into patient files.
• Payer Liaison: Proactively follow up on outstanding, denied, or rejected claims, fighting the good fight on behalf of our practices.
• Administrative Accuracy: Audit aging reports, process co-pays, and post insurance payments with sharp, reliable attention to detail.

Billing & Insurance Coordinator

• Manage the daily billing and ensure timely accurate clean claims
• Claim reviews and resolves billing daily claim edits and ensuring compliance with Insurance billing policies and regulations
• Maintain a list of split billing requirements by payer
• Review claims that are pended for edits and resolve
• Prepare and submit accurate claims for patient services
• Review patient accounts and reconcile payments with secondary payers
• Ensure all billing and collection practices are compliant with CMS regulations, HIPAA, and company policies
• Maintain accurate records of all claims and ensure proper documentation in the patient account system
• Meet daily productivity and quality standards as assigned
• Work with internal departments to address issues or disputes affecting patient accounts
• Assist management in maintaining or reducing account receivable (AR) days

• Review and reconcile client eligibility and payments.
• Determines active, retiree, and COBRA eligibility based on plan sponsor plan provisions.
• Processes enrollment eligibility files and completes enrollment edits in system queues.
• Enter new employees and dependents into the system and make changes to existing records as required.
• Ensure identification cards are ordered correctly and timely according to plan sponsor and company guidelines.
• Post & reconcile client payments.
• Process vendor disbursements and reconciles payments according to vendor requirements and company guidelines.
• Disburse end-of-the-month reports to clients as required.
• Completes the review of and responds to vendor discrepancy reports as assigned.
• Interprets and communicates COBRA and HIPAA regulations.
• Handles self-pay administration according to plan provisions and guidelines.
• Answers email and call inquiries from participants, clients, vendors and local unions.
• Provides customer service and maintains effective relationships with clients, participants, agents, and brokers.
• Update and maintain Client Policy and Procedure document.
• Adheres to and is responsible for the understanding of company eligibility policies and procedures and resources.
• Meets department production and quality metrics.
• Participates in and contributes to mandatory department meetings, training, and company events.
• Completes company, department, or plan sponsor special projects.
• Follows company attendance policy and adheres to provisions in the collective bargaining agreement.
• Upholds and exemplifies company values.
• Performs other duties as assigned.
• Review and process all internal and client specific weekly and/or monthly reports.
• Email and Group folder organization.

Billing & Eligibility Coordinator

• Set up and maintain project data, contracts, and client information in the ERP system (Deltek Vantagepoint)
• Own monthly invoicing for 20+ Engagement Managers, reviewing and finalizing 100+ pre-bills per cycle
• Execute complex billing, including split-party, multi-payor, and flat-fee invoicing
• Coordinate with Engagement Managers to resolve discrepancies and ensure timely, accurate billing
• Ensure all electronic billing guidelines are strictly followed and e-billing issues are resolved swiftly
• Maintain comprehensive, up-to-date billing records, client preferences, approvals, and process documentation
• Ensure compliance with internal controls, audit requirements, and client-specific billing agreements
• Monitor WIP, proactively flag at-risk billings, and partner with managers to minimize write-offs
• Analyze aged accounts receivable and unapplied cash, collaborating bi-monthly with managers to resolve outstanding or disputed items
• Respond to internal and external billing inquiries professionally and in a timely manner
• Provide regular billing and AR reports for management review
• Serve as primary billing point of contact during team absences
• Support billing teammates as needed and participate in special projects to optimize billing process.

Billing Specialist jobs in United States

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Medicaid Billing Specialist

Medicare Specialist – Medicare Billing

Senior Billing & Collection Specialist

Group Product Manager – Billing Modernization

Billing Clerk

Enrollment & Billing Administrator

eBilling Analyst

Billing Operations Supervisor

Medicaid Billing Clerk

Benefits Billing/Operations Analyst

AR Lead – Billing and Collections

DME Pharmacy Billing Specialist

Billing Specialist

Billing Coordinator

Program Billing Coordinator – Community Based, Virtual Services

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

Billing & Insurance Coordinator

Billing Specialist

Billing & Eligibility Coordinator

Project Billing Specialist