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Appalachian Regional Healthcare (ARH)

Clinic Billing Specialist

Appalachian Regional Healthcare (ARH), Frankfort, Kentucky, United States

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Clinic Billing Specialist

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Appalachian Regional Healthcare (ARH)

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Under general supervision, the Clinic Billing and Follow-Up Specialist handles essential billing and insurance follow-up functions. This role requires a fundamental understanding of insurance claim processing, knowledge of HCFA claim forms, and the ability to interpret insurance explanation of benefits (EOBs), handle denials, and perform follow-up with insurers to ensure claims resolution. The position encompasses business office responsibilities related to patient accounts, including charge import, appeals, diagnostics and procedural coding, and claim follow-up with third‑party payers to achieve a zero-balance resolution.

Responsibilities

Promote the mission, vision, and values of the organization

Import charges from queues in a timely manner and append modifiers or any required information for claim transmission

Review daily accounts that are ready to be billed in Waystar from Meditech

Initiate correction on all claims with errors by the designated time

Follow up on any correspondence that may have been received on that day or the previous day

Cross train on billing all lines of business to the different payers

Pull listing of all accounts assigned to be follow up by specific payer

Diagnostic and procedural coding

Follow‑Up Responsibilities

Resubmit primary, secondary, and tertiary claims per respective regulations and policies

Communicate with third‑party representatives as necessary to complete claims processing and/or resolve problem claims

Follow‑up daily on post‑processing activity including rejected billings, adjustments, rebilling, and denied claims for accounts

Maintain accounts receivable detail of accounts through tasking

Maintain standards per payer for percentage accounts > 90 days

Work minimum standard number of accounts per payer per day

Meet or exceed collection goals by payer each month

Work all assigned accounts as assigned, depending on balance

Complete appeals as required

Participate in educational activities and attend monthly department staff meetings

Maintain confidentiality: adhere to all HIPAA guidelines/regulations

Other duties as assigned from time to time

Qualifications

High School Diploma or GED

Six months previous experience in clinic registration, billing and collections, financial counseling, or customer service preferred

Knowledge of medical terminology preferred

Basic computer proficiency

Typing speed: minimum 40 WPM

Familiarity with CPT and ICD‑9 coding is helpful

Good written and verbal communication skills are essential for account follow‑up

Seniority level

Entry level

Employment type

Full‑time

Job function

Accounting/Auditing and Finance

Industries

Hospitals and Health Care

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