Professional Billing Specialist – Commercial Insurance

Department: Business Office – Professional (Pro) Side
Schedule: Full-Time
Reports To: Business Office Manager

The Professional Billing Specialist – Commercial Insurance is responsible for billing, follow‑up, and collections for professional services billed to commercial insurance carriers. This role supports accurate coding, claim submission, and timely reimbursement for provider‑based services.

• Submit professional claims to commercial insurance carriers
• Follow up on unpaid, denied, or underpaid claims
• Review EOBs and address billing discrepancies
• Work closely with coding and clinical staff to resolve claim issues
• Correct and resubmit claims as needed
  
  Maintain accurate account notes and documentation
• Ensure compliance with payer policies and HIPAA regulations

• High school diploma or equivalent required
• Previous professional billing or medical office billing experience preferred
• Experience with commercial insurance billing preferred
• Knowledge of CPT, ICD-10, and insurance claim processes
• Strong attention to detail and time-management skills
• Ability to work independently and as part of a team