Billing Agent Specialist

SUMMARY/OBJECTIVE:
The Billing Specialist Agent is responsible for supporting professional service billing operations, including insurance claims, patient billing, payment processing, claims submission, denial management, accounts receivable follow-up, and account resolution. This role ensures accurate and timely billing activities, follows up on unpaid claims and outstanding patient balances, and supports effective revenue cycle operations. The Billing Specialist Agent collaborates with patients, insurance companies, providers, and internal departments to resolve billing issues, obtain appropriate reimbursement, maintain accurate account information, and provide responsive customer service.

This position is responsible for maintaining accurate documentation, complying with applicable healthcare regulations and organizational policies, and supporting efficient revenue cycle processes. The ideal candidate is detail-oriented, organized, analytical, and customer-service focused, with experience in medical billing, insurance verification, accounts receivable, claims processing, and/or healthcare revenue cycle operations. The successful candidate will demonstrate the ability to manage multiple priorities, investigate billing issues, communicate effectively with patients and insurance representatives, and maintain accuracy in a fast-paced healthcare environment.

RESPONSIBILTIES/DUTIES Billing & Claims Management
· Prepare and submit claims to insurance companies accurately and in a timely manner.
· Receive and process payments from insurance companies and patients, including posting payments and reconciling accounts.
· Investigate and resolve denied or unpaid claims and resubmit claims when necessary.
· Document and maintain accurate records for each open claim.
· Perform necessary follow-up to ensure proper payment is received.
· Identify, research, and resolve billing issues and account discrepancies.
· Work daily insurance correspondence as needed.
· Work assigned hold buckets and resolve outstanding account items.
· Follow up on the status of past insurance claims and patient accounts.
· Perform collection activities, including contacting patients by phone, correcting claims, and resubmitting claims.
· Verify insurance eligibility for Psychiatry, Neurology, and Primary Care Providers.
· Utilize EMR and billing systems to manage patient information, insurance denials, billing records, and account activity. Patient & Insurance Support
· Answer patient billing questions and explain invoices, balances, payments, and account activity.
· Assist patients with payment plans and other billing-related inquiries as appropriate.
· Answer questions from patients, coworkers, insurance companies, and other relevant stakeholders.
· Communicate professionally and courteously with patients and insurance representatives regarding account and billing matters.
· Maintain confidentiality of patient, financial, and company information in accordance with HIPAA and organizational policies. Revenue Cycle & Operational Support
· Support accurate and timely revenue cycle activities and account resolution.
· Maintain accurate and complete documentation within applicable billing and EMR systems.
· Identify recurring billing issues and communicate potential process improvements to appropriate leadership.
· Follow established billing, collection, documentation, and quality assurance procedures.
· Maintain compliance with HIPAA regulations, billing laws, payer requirements, and organizational policies.
· Meet established productivity, quality, accuracy, and turnaround-time expectations.
· Support departmental goals and operational initiatives.
· Perform other duties and special projects as assigned. ADA Statement Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions of this position. EEOC Disclosure Salience is an Equal Opportunity Employer and is committed to creating an inclusive workplace. Employment decisions are made without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, disability, genetic…