Billing Specialist

• Drive timely and accurate reimbursement by managing pharmacy claim billing, collections, and follow-up activities
• Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies
• Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps
• Monitor accounts receivable and manage outstanding balances through payer or patient outreach
• Prepare, submit, and track payer appeals within required timeframes
• Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed
• Identify and correct billing or submission errors impacting reimbursement
• Maintain documentation of collection activity in patient notes and reporting tools
• Partner with teammates and leaders to identify workflow improvements that strengthen efficiency, compliance, and financial performance
• Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization

Senior Enrollment/Billing Representative, Home Infusion

• Post payments from patients and third parties
• Adjust patients’ accounts
• Process incoming payments
• Verify write-offs
• Fax medical records to third parties as requested
• Scan documents
• Confirm refunds to patients and third parties
• Identify payer issues
• Perform other duties as assigned

Billing Clerk

• Manage the dental revenue cycle, including insurance payment posting and claim processing
• Submit clean claims and resolve claim rejections and denials
• Apply insurance payment adjustments and Explanation of Benefits (EOB) procedures
• Maintain accounts receivable and work to reduce insurance aging
• Utilize payer portals, clearinghouses, and practice management software
• Ensure HIPAA compliance and accurate patient account documentation
• Support a portfolio of 4 to 5 dental practice clients

Dental Insurance Billing Specialist

• Prepare and distribute monthly pre-bills and ad hoc billing submissions according to client and attorney requirements
• Review and process narrative revisions, time adjustments, and cost corrections for billing accuracy and compliance
• Generate and finalize client invoices accurately and promptly
• Prepare LEDES and other electronic billing file formats for client-specific e-billing requirements
• Submit invoices through electronic billing platforms and vendor portals
• Monitor invoice submissions, resolve transmission issues, and ensure successful delivery and acceptance of e-bills
• Maintain records of client billing guidelines, outside counsel guidelines, and billing requirements
• Establish and maintain client-specific rate structures, exception rates, and billing arrangements in financial systems
• Manage an assigned portfolio of attorneys and clients, maintaining billing preferences, proforma status, billing schedules, and special requirements
• Partner with attorneys, legal assistants, and finance team members to address billing inquiries and complete billing activities
• Identify and escalate billing issues affecting invoice submission, client compliance, or revenue realization

Billing Specialist jobs in Pennsylvania

Senior Enrollment/Billing Representative, Home Infusion

Billing Clerk

Dental Insurance Billing Specialist

Billing Coordinator