Surgery Center Billing Specialist (Healthcare)
*Hybrid Position*
We are seeking a detail-oriented and experienced Surgery Center Billing Specialist to join our team. The Billing Specialist will be responsible for handling all aspects of billing and collections for the surgery center. This includes ensuring accurate and timely submission of claims to insurance companies, processing patient billing, and following up on outstanding accounts to ensure proper reimbursement for services provided.
Key Responsibilities:
- Accurately and timely submit insurance claims for surgery center services, including outpatient procedures, consultations, and other services provided.
- Ensure all claims are submitted in accordance with insurance policies, protocols, and coding requirements.
- Ensure patient insurance information and eligibility accurately obtained.
- Process patient statements and follow up on outstanding patient balances, including answering patient billing inquiries and resolving billing discrepancies.
- Work closely with insurance companies to resolve denied claims, underpayments, and other payment issues.
- Track, research, and reconcile patient and insurance accounts to ensure accurate billing and collections.
- Maintain up-to-date knowledge of insurance regulations, payer-specific requirements, and industry best practices.
- Coordinate with clinical staff, management, and external vendors to ensure smooth billing and claims processing.
- Prepare and maintain detailed reports of billing activity, outstanding balances, and revenue cycle performance.
- Ensure compliance with all applicable healthcare billing regulations, including HIPAA and other relevant federal and state laws.
- High school diploma or equivalent required; additional certification in medical billing or coding preferred (e.g., CPC, CCS).
- Minimum of 2-3 years of experience in medical billing, preferably in a surgery center or outpatient facility.
- Strong understanding of healthcare insurance, CPT, ICD-10, and HCPCS coding.
- Experience with electronic health record (EHR) and practice management software (e.g., Epic, Kareo, AdvancedMD).
- Excellent communication skills with the ability to effectively interact with insurance providers, patients, and staff.
- Strong attention to detail, organizational skills, and the ability to manage multiple tasks simultaneously.
- Knowledge of medical terminology and an understanding of the surgical procedures performed at the center.
Preferred Skills:
- Experience with surgery center billing and revenue cycle management.
- Familiarity with government payer programs (Medicare, Medicaid) and commercial insurance plans.
- Ability to work independently, take initiative, and troubleshoot billing issues.
Physical Demands:
- Manual and finger dexterity and eye-hand coordination to enter data and operate office equipment
- Corrected vision and hearing within normal range to observe and communicate with patients, providers, and staff
- Frequently remaining in a stationary position, often sitting for prolonged periods working on a computer, telephone, copy/fax machine, and other office equipment
- Occasional standing and walking required
