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

• Assist patients with billing, explanation of benefits (EOB), deductible, Medicare, and insurance questions
• Research patient accounts and resolve basic billing issues
• Update insurance information
• Handle high-volume calls while providing compassionate customer service
• Support a major Epic transition

Patient Billing Representative

• Assist patients with billing, EOB, deductible, Medicare, and insurance questions
• Research accounts and resolve basic billing issues
• Update insurance information
• Handle high-volume calls while providing compassionate customer service
• Support a major Epic transition

• Manage assigned client billing portfolios from prebill preparation and attorney edits through invoice finalization and delivery
• Review time entries, matter details and supporting documentation for accuracy and compliance with client billing guidelines
• Coordinate with attorneys and internal teams to obtain approvals, clarify edits, and meet monthly billing deadlines
• Submit invoices through client portals and e-billing platforms, monitor status, and resolve client rejections
• Maintain accurate client, matter and billing instruction records in the firm's financial systems and tracking tools
• Perform quality-control reviews, research billing discrepancies, and respond promptly to internal and client billing inquiries
• Support month-end and year-end billing activities, reporting, audit requests, and continuous process improvements

Billing Coordinator

• Join the Revenue Management Department as a Legal Billing Specialist
• Prepare invoices through the full invoice lifecycle
• Edit prebills via Prebill Viewer and Aderant based on Billing Attorney requests
• Generate a high volume of complex client invoices via Aderant
• Ensure invoices comply with billing guidelines and include required supporting documentation
• Submit electronic bills via EHub with supporting documentation
• Monitor and promptly address invoice rejections, reductions, and appeals
• Respond to billing inquiries from attorneys, clients, and administrative staff
• Undertake special projects and ad hoc reports
• Collaborate across teams to deliver effective billing services
• Report to the Billing Manager of Revenue Management
• Work remotely from the New Jersey office, with occasional onsite training and business travel as needed

Legal Billing Specialist

• Investigate and analyze Motor Vehicle Accident accounts to identify and coordinate insurance benefits and resolve outstanding client balances
• Work closely with patients and insurance carriers until first-party claims are processed and resolved
• Handle patient health information (PHI) while maintaining strict privacy and security of confidential and proprietary information
• Conduct online medical research of MVA claim payments using EnableComp’s proprietary software, systems, tools, and other medical websites
• Research, request, acquire, and review medical records, provider notes, explanations of benefits, and supporting documentation
• Submit hospital claims to insurance companies to ensure prompt and accurate reimbursement
• Follow up with payers to update claim systems accurately and verify receipt of supporting documentation
• Make key decisions to facilitate claim resolution
• Prepare accurate MVA billing packets and submit them with required documentation
• Communicate with patients and insurance adjusters regarding claim status and timely resolution prospects
• Review payer EOBs and determine appropriate actions for claim balances after auto insurance claim resolution
• Perform other duties as required

Revenue Specialist, First Party Billing

• Lead denial management and appeals strategy across all payer types
• Define and track overturn rates, appeal timelines, and recovery performance
• Serve as an internal expert on payer policies and medical necessity criteria for laboratory testing
• Interpret payer policies and guide teams in defending medical necessity in appeals
• Identify payer behavior patterns to inform contracting strategy and escalation pathways
• Partner with eligibility, prior authorization, coding, and billing teams to proactively prevent denials
• Audit BPO/vendor performance, identify workflow gaps, enforce accountability, and drive improvements
• Develop job aids and standardized workflows
• Analyze denial trends to distinguish avoidable operational issues from systemic or payer-driven challenges
• Translate denial and appeals workflows into system logic with engineering and vendors
• Define requirements for rules-based workflows, denial routing, and appeal triggers in billing systems such as AMD
• Support rules engines, RPA, and AI-driven workflow automation initiatives
• Lead UAT and QA for system changes
• Identify opportunities to transition processes toward scalable, low-touch or unattended workflows
• Identify automation edge cases, failure points, and logic gaps before and after deployment
• Analyze datasets using Power BI, SQL, Excel, or Snowflake to quantify denial drivers and financial impact

Associate Director, Billing Strategy – Denials & Appeals

• Actively manage 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 affecting reimbursement
• Maintain timely 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 in delivering specialty pharmacy and infusion services

• Prepare and submit construction pay applications to general contractors and other customers according to contract requirements and billing schedules
• Review contracts, purchase orders, schedules of values, and related documentation to understand billing requirements, payment terms, retainage, and financial obligations
• Administer sales tax changes and manage customer reseller permits
• Reconcile internal sales orders and project activity with customer contracts and purchase orders
• Identify scope and order differences and coordinate with internal teams on required change orders
• Track change orders and ensure approved changes are reflected in contract values, schedules of values, billings, and accounts receivable
• Prepare, execute, and track conditional and unconditional lien releases/waivers and other payment documentation
• Monitor retainage and ensure amounts are billed and collected when requirements are satisfied
• Maintain accurate records of pay applications, lien releases, change orders, contracts, purchase orders, and supporting documentation
• Track outstanding receivables and follow up with customers regarding payment status, discrepancies, missing documentation, and payment delays
• Research and resolve billing and payment discrepancies with customers and internal departments
• Communicate with general contractors, project accountants, accounts payable departments, project managers, and internal stakeholders
• Maintain accurate aging information and provide updates on significant past-due balances or collection issues
• Help improve processes and controls for construction billing, contract reconciliation, and accounts receivable

Construction Billing Specialist

• Work assigned work queues while following related policies and procedures
• Complete responsibilities in Cash Posting, Cash Control, Credit, and Data Entry/Scanning
• Post payments and adjustments accurately and timely to patient accounts from multiple sources
• Interpret EOBs and transfer money to secondary insurance or patient liability
• Scan and index supporting documentation for manually posted payments
• Research payments and adjustments resulting in credit balances or undistributed funds
• Balance and track cash and adjustment posting daily
• Reconcile unapplied cash accounts and post denial information
• Research missing payments with payers or clearinghouses
• Review insurance and patient account credits to determine whether refunds are required
• Identify credit balance accounts through reports and work queues
• Research, process, document, and balance refunds
• Apply patient overpayments to outstanding balances
• Review and resolve undistributed payments
• Follow up on unpaid claims and verify/update patient demographics and insurance information
• Maintain knowledge of payer groups, billing practices, and regulations
• Run patient eligibility checks, verify insurance, and request outside records
• Translate payer denial codes to UAMS standard denial codes
• Investigate recoupments, interest payments, and miscellaneous payments
• Claim payments, complete Records of Deposit, split funds, and reconcile bank reports, EFTs, insurance checks, personal payments, and Point of Service payments
• Prepare batches for manual payment posting and ensure all money is accounted for and allocated
• Research payments and interact with insurance carriers and other agencies
• Coordinate workflow and support a productive team environment
• Attend insurance carrier-provided training as needed
• Perform other duties and responsibilities as needed

Billing Specialist jobs in United States

Senior Enrollment/Billing Representative, Home Infusion

Patient Billing Representative

Patient Billing Representative

Billing Coordinator

Legal Billing Specialist

Revenue Specialist, First Party Billing

Associate Director, Billing Strategy – Denials & Appeals

Senior Enrollment/Billing Representative, Home Infusion

Construction Billing Specialist

Associate Clinical Billing Specialist