Company: SFP Health Group
Job title: Medical Billing Specialist
Division/Department: Clinical Operations
Reports to: COO – Chief Operating Officer
Job Summary:
The Billing Data Entry Specialist is responsible for accurately entering, reviewing, and maintaining patient, insurance, billing, and payment information within the organization’s billing and electronic health record systems. This position supports the billing process by ensuring that information is complete, accurate, and entered within established deadlines.
The Billing Data Entry Specialist works closely with the billing, clinical, front-office, and administrative teams to resolve missing or incorrect information and support the timely submission and processing of claims.
Essential Duties and Responsibilities
- Enter patient demographics, insurance information, charges, procedure codes, payments, adjustments, and other billing-related information into theappropriate system.
- Review billing documentation for completeness and accuracy before entering orsubmittinginformation.
- Verify that patient and insurance information matches supporting documentation.
- Identifymissing, incomplete, or inconsistent information and follow up with theappropriate departmentfor clarification.
- Assistwith the preparation and submission of insurance claimsin accordance withestablished billing procedures.
- Review claims for basic data-entry errors, including incorrect patient information, insurance details, dates of service, provider information, and billing codes.
- Correct rejected claims or billing records when the issue is related to inaccurate or incomplete data.
- Enter payments, contractual adjustments, write-offs, and other account updates as assigned.
- Maintainaccurateand organized electronic billing records.
- Scan, upload, and properly categorize billing documents within the designated system.
- Assistwith reconciling billing reports andidentifyingdiscrepancies.
- Monitor assigned work queues and complete tasks within established turnaround times.
- Communicate professionally with internal departmentsregardingmissing documentation or billing concerns.
- Maintain the confidentiality of patient, financial, and organizational information.
- Follow HIPAA requirements, organizational policies, and all applicable billing and compliance procedures.
- Participate in training andprocess-improvementactivities asrequired.
- Performadditionalbilling or administrative duties as assigned.
Required Qualifications