Patient Billing Support Specialist

Patient Billing Support Specialist

Position Overview

ThePatient Billing Support Specialist is responsible for delivering exceptional patient customer service, providing administrative support, and ensuring accurate, timely, and compliant revenue cycle billing processes.

This role serves as a key point of contact for patient billing inquiries, assists with account resolution, and supports claims management, denial resolution, and reimbursement activities.

The Patient Billing Support Specialist directly contributes to patient satisfaction, operational efficiency, and financial performance by maintaining accurate billing records, reducing claim denials, and supporting timely reimbursement.

Core Responsibilities

Patient Customer Service & Support

• Respond to patient inquiries regarding billing, account balances, insurance claims, and payment status.
• Provide professional, friendly, and timely assistance through phone, email, and other communication channels.
• Explain billing statements, insurance payments, and patient financial responsibilities clearly and accurately.
• Investigate and resolve patient billing concerns and account discrepancies.
• Follow up on unresolved inquiries to ensure timely resolution and patient satisfaction.
• Maintain accurate documentation of patient interactions and account updates.

Administrative Support

• Perform daily administrative tasks to support patient billing and revenue cycle operations.
• Maintain accurate patient records, billing documentation, and account information.
• Assist with data entry, document processing, and account updates.
• Coordinate with internal departments to resolve billing and administrative issues.
• Manage assigned tasks efficiently while meeting established deadlines.
• Maintain organized records and ensure confidentiality of patient information.

Claims Management

• Prepare, review, and submit insurance claims accurately and on time.
• Monitor claim status and follow up on unpaid or outstanding claims.
• Verify patient demographics, insurance information, and billing details.
• Identify billing discrepancies and make necessary corrections.
• Communicate with insurance payers to resolve claim-related issues.
• Support timely reimbursement and reduction of outstanding accounts receivable.

Denial Resolution

• Identify and investigate the root causes of claim denials and rejections.
• Correct and resubmit denied or rejected claims efficiently.
• Follow up with insurance payers regarding outstanding denials.
• Document denial reasons, corrective actions, and resolution outcomes.
• Identify recurring billing issues and help prevent future denials.

Data Accuracy & Compliance

• Ensure patient billing information and applicable coding data are accurate.
• Maintain compliance with insurance payer requirements and organizational policies.
• Protect confidential patient information in accordance with HIPAA and applicable regulations.
• Maintain accurate documentation to support billing audits and reporting.
• Identify opportunities to improve billing accuracy and administrative processes.

Performance Expectations

Patient Customer Service

• Timely and professional responses to patient inquiries.
• Effective resolution of patient billing concerns.
• Accurate documentation of patient communications.
• Consistent patient satisfaction and service quality.

Billing & Revenue Cycle

• Claim submission accuracy rate.
• Claim denial rate and resolution time.
• Timely follow-up on unpaid claims.
• Days in Accounts Receivable (AR).
• Accuracy of billing records and account updates.

Administrative Performance

• Timely completion of daily administrative responsibilities.
• Accurate data entry and record maintenance.
• Effective organization and prioritization of assigned tasks.
• Consistent follow-through and accountability.

Required Skills & Qualifications

• Experience in customer service, administrative support, healthcare billing, or revenue cycle management preferred.
• Strong written and verbal communication skills.
• Excellent attention to detail and organizational skills.
• Ability to manage multiple tasks while maintaining accuracy.
• Strong problem-solving skills and a patient-focused approach.
• Familiarity with insurance claims, billing processes, and payment follow-up preferred.
• Proficiency in computer systems and data entry.
• Ability to work independently and collaboratively.
• Commitment to patient confidentiality and professional conduct.

Culture Fit

• Patient-Focused: Demonstrates empathy, professionalism, and a commitment to positive patient experiences.
• Detail-Oriented: Prioritizes accuracy in billing, documentation, and administrative tasks.
• Accountable: Takes ownership of responsibilities and follows through on outstanding issues.
• Solution-Driven: Proactively identifies problems and works toward timely resolution.
• Team-Oriented: Collaborates effectively with coworkers and other departments.
• Adaptable: Balances patient service, administrative responsibilities, and billing priorities.
• Results-Driven: Focuses on improving patient satisfaction, billing accuracy, and financial outcomes.