POSITION SUMMARY:

Pittsburgh Gastroenterology Associates is a private practice GI specialty group. We are seeking a detail-oriented and experienced Healthcare Billing Specialist to join our team. This role is ideal for someone with a strong background in medical billing and accounts receivable (A/R), who can also take ownership of insurance authorization processes and personal balance collections. The ideal candidate will be proactive, organized, and committed to ensuring accurate and timely reimbursement for healthcare services.

QUALIFICATIONS:

• Minimum 2 years of experience in medical billing and A/R.
• Proven experience with insurance authorization processes and patient collections.
• Strong understanding of healthcare billing systems and EHR platforms.
• Excellent communication and customer service skills.
• Ability to manage multiple tasks and meet deadlines.
• High level of accuracy and attention to detail.

KEY RESPONSIBILITIES:

• Primary responsibility assist with prior authorizations needed for certain procedures
• Follow up with patients on personal balances due and offer payment solutions to include CareCredit.

SECONDARY RESPONSIBILITIES MAY INCLUDE:

• Process and submit insurance claims accurately and efficiently.
• Follow up on unpaid claims and manage A/R to ensure timely collections.
• Obtain and verify insurance authorizations and precertifications for procedures and services.
• Communicate with insurance companies to resolve claim issues and denials.
• Contact patients regarding outstanding balances and set up payment arrangements when necessary.
• Maintain uptodate knowledge of insurance guidelines and billing regulations.
• Collaborate with clinical and administrative staff to ensure proper documentation and coding.
• Accurately post payments and adjustments in the billing system.
• Generate and review aging reports to prioritize collection efforts.