Job Description

Job Description

About Us:

We are a dedicated ENT (Ear, Nose & Throat) specialist practice committed to providing exceptional patient care and service. We’re seeking a detail-oriented and motivated  Medical Billing Specialist to join our team. The ideal candidate will have experience in healthcare billing and collections, with strong knowledge of CPT, ICD-10, and HCPCS coding.

Responsibilities

Billing & Collections

• Follow established billing and collection protocols to ensure accurate and timely reimbursements.
• Review and manage patient and insurance accounts to ensure prompt payment.
• Apply knowledge of  CPT, ICD-10, and HCPCS coding for proper claim submission.
• Identify and resolve payor issues that may cause payment delays.

Claims & Appeals

• Submit all claims accurately and promptly.
• Appeal denied claims and manage both  front-end authorizations and  back-end denials .
• Utilize insurance carrier websites and  Salesforce for efficient follow-up and tracking.
• Maintain compliance with  HIPAA, confidentiality, and privacy regulations.
• Conduct research using available resources to complete referral submissions and updates.

Communication & Collaboration

• Initiate outbound calls to insurance companies to resolve claims and payment issues.
• Handle high-volume inbound and outbound calls while acting as a liaison between insurance carriers, patients, and internal staff.
• Collaborate with internal teams to streamline  referral management and  prior authorization processes.
• Maintain thorough documentation of all communications, actions, and outcomes.
• Perform other duties as assigned.

Qualifications

• High school diploma or equivalent required.
• 2–5 years of healthcare billing, collections, or financial experience preferred.
• Working knowledge of  HCPCS, CPT, and ICD-10coding.
• Proven experience collecting payments from insurance companies.
• Strong communication, organizational, and problem-solving skills.
• Ability to work independently and as part of a team in a fast-paced medical office setting.

Benefits

• Competitive pay based on experience
• Health, dental, and vision insurance
• Paid time off and holidays
• Opportunities for professional growth and development

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