Billing Specialist II

Job description

Description Position Summary: The Billing Specialist II is responsible for advanced billing functions, including comprehensive claim review and submission, managing complex cases, and ensuring compliance with detailed payer requirements. This role also supports training of junior billing staff, participates in audits, and assists in refining processes to support accurate reimbursement and compliance. Essential Duties and Responsibilities: - Verify patient demographic and insurance data, including complex or non-standard cases. - Prepare, review, and submit electronic and paper claims to a variety of payers and government programs. - Identify and resolve standard and complex claim rejections. - Maintain current knowledge of internal billing protocols, coding updates, and payer-specific requirements. - Enter and review census data from multiple facilities in Monday.com and billing platforms. - Follow established billing procedures and escalate irregular issues as needed. - Provide guidance to entry-level billing specialists to support team opera ons. - Participate in internal audits and recommend adjustments to billing policies and workflows. - Maintain compliance with HIPAA and data...