Patient Access & Billing Specialist

The Patient Access & Billing Specialist is responsible for supporting both patient access functions and end-to-end revenue cycle operations for ambulatory surgery center (ASC) and clinic-based services. This role manages medical billing workflows including claims submission, accounts receivable follow-up, denial resolution, and insurance reimbursement across multiple service types.

This position plays a key role in ensuring accurate and timely reimbursement by actively working aging accounts, resolving billing discrepancies, and supporting payer communication. While primarily focused on billing and revenue cycle functions, this role may provide occasional front desk coverage as needed for staffing support.

Essential Functions/Responsibilities: 

Billing & Revenue Cycle:

• Manage billing workflows for both ASC surgical procedures and clinic encounters
• Submit, track, and follow up on insurance claims across multiple payer types
• Work aging accounts receivable, prioritizing overdue balances and high-dollar accounts
• Research, analyze, and resolve claim denials, underpayments, and rejections
• Communicate with insurance carriers regarding claim status, appeals, and authorizations
• Submit authorizations for procedures, surgeries, outgoing referrals, etc.
• Post payments, adjustments, and contractual allowances accurately
• Monitor aging reports and take proactive steps to reduce outstanding AR
• Ensure accuracy of claims through documentation review and charge validation
• Collaborate with providers and clinical staff to obtain missing or corrected documentation
• Maintain detailed records of billing activity, payer communication, and resolution outcomes
• Escalate complex or high-value billing issues to leadership when appropriate

Patient Access / Front Desk Support:

• Provide front desk coverage during staffing shortages or high-volume periods
• Greet and assist patients in a professional and courteous manner
• Answer phones, schedule appointments, and manage provider calendars as needed
• Register new patients and update demographics and insurance information
• Verify insurance eligibility and collect patient payments (copays, balances, deductibles)

Required Skills and Experience:

• High school diploma or equivalent required; Associate degree preferred
• 1–3 years of medical billing or revenue cycle experience required
• Experience with ASC billing, clinic billing, or multi-setting healthcare billing strongly preferred
• Strong understanding of insurance billing processes, claims management, and AR follow-up
• Experience working aging reports and resolving denied or unpaid claims
• Familiarity with CPT, ICD-10 coding, and medical terminology preferred
• Strong analytical and problem-solving skills with ability to prioritize workload
• Excellent communication skills (written and verbal) for payer and patient interaction
• High attention to detail and accuracy in financial and billing data
• Ability to work independently and manage multiple billing queues or tasks
• Proficiency with billing systems, EMR/EHR platforms, and Microsoft Office (especially Excel)
• Strong customer service mindset and professionalism in patient interactions
• Ability to maintain confidentiality and comply with HIPAA regulations

Pay Range:

$19 – $23/hour based on experience

Benefits:

• Health Insurance (Single & Family plans available)
• Life Insurance
• Disability Insurance
• 401(k) with Company Match
• Employee Discount Program
• Paid Time Off (PTO)
• Paid Holidays

Physical Requirements:

• Ability to sit and work at a computer for extended periods
• Frequent use of hands for typing and data entry
• Occasional lifting up to 50 pounds and carrying up to 25 pounds
• Occasional bending, reaching, and movement within the office environment
• Ability to maintain visual acuity for detailed document and screen review