Billing Specialist

This position is ON-SITE in Tucson, Arizona

The Billing Specialist is responsible for processing insurance claims in a timely and accurate manner. This includes ensuring all required elements—diagnosis codes, treatment codes, charges, modifiers, and provider details—are complete and correct prior to claim submission.

• Submit insurance claims accurately and promptly, ensuring all coding and billing elements are complete.
• Work assigned payers to ensure claims are paid within 60 days of the billing date.
• Prioritize workloads by balancing the oldest and highest dollar claims with current claims, reviewing all accounts monthly.
• Conduct necessary research and submit timely appeals or reconsideration requests to insurance payers when needed.
• Verify accuracy of claim information when resubmitting electronically or by paper.
• Process and respond to medical record requests within payer‑specified time frames.
• Assist with incoming phone calls, including answering patient and payer questions, accepting payments, and providing general support.
• Ensure compliance with medical terminology, CPT, ICD‑10, NCCI edits, LCD edits, and all applicable coding laws and regulations.
• Ensure coding is used aligned with reimbursable services and meets payer requirements.
• Always maintain patient confidentiality in accordance with HIPAA guidelines.
• Perform light administrative duties as needed and complete other tasks as assigned by the Revenue Cycle Manager or department supervisor.

Minimum two years’ experience in Medical Insurance billing experience required.

• Proficiency with internet navigation, Microsoft Office applications, and EMR software.
• Strong interpersonal skills; ability to work independently and collaboratively.
• Knowledge of HIPAA regulations and commitment to maintaining confidentiality.
• Excellent accuracy, efficiency, and attention to detail.
• Strong understanding of medical terminology, CPT, and ICD‑10 coding.
• Ability to meet deadlines consistently.
• Timely follow‑up on insurance claim denials, exceptions, or exclusions.
• Regular attendance at monthly staff meetings and required continuing education sessions.