Job Details

Clinical Billing Specialist — Job Description (No Insurance Responsibilities)

Position Overview The Clinical Billing Specialist is responsible for accurately managing patient billing, coding, and payment processing within the clinic's revenue cycle. This role ensures timely invoicing, proper documentation, and efficient financial workflows while partnering closely with clinical and administrative staff.

Key Responsibilities

Billing & Claims Processing (Non-Insurance)

Prepare and submit patient invoices promptly and accurately.

Review clinical documentation to ensure correct CPT, ICD-10, and HCPCS coding.

Process patient charges, adjustments, refunds, and account updates.

Post payments received from patients or third-party payment programs (non-insurance).

Maintain accurate financial records and ensure all billing data is up to date.

Patient Billing Support

Communicate with patients regarding statements, balances, and payment options.

Provide clear explanations of charges, clinic fees, and financial policies.

Set up and manage patient payment plans as needed.

Respond to patient billing inquiries in a professional and timely manner.

Documentation & Compliance

Ensure all billing activity complies with clinic policies, HIPAA requirements, and healthcare documentation standards.

Work with clinicians to verify that services rendered are documented clearly and accurately.

Maintain organized billing files and ensure data confidentiality.

Revenue Cycle & Administrative Support

Reconcile daily billing reports and ensure accuracy of transactions.

Identify discrepancies or billing errors and take corrective action.

Assist with month-end financial reporting related to billing performance.

Support continuous improvement initiatives related to the clinic's revenue cycle.

Qualifications

Required

High school diploma or equivalent.

1–2 years of medical billing, healthcare administration, or related experience.

Strong understanding of medical terminology and coding (CPT, ICD-10, HCPCS).

Strong attention to detail, accuracy, and time management.

Proficiency with EHR/EMR systems and billing software.

Excellent communication and customer service skills.

Preferred

Certification in medical billing or coding (e.g., CPC, CPB, CBCS).

Experience working in a clinical or outpatient setting.

Familiarity with cash posting or patient financial services.

Work Environment

Full Time

On-site