Billing & Insurance Specialist in Philadelphia, PA at Public Health Management Corporation

Date Posted: 2/17/2021

Job Snapshot

Job Description

A Billing and Insurance Specialist offers financial advice and assistance to patients regarding medical bills and applying for insurance. They are the liaison between patients and their insurance companies; often coordinating payments and answering questions from both parties. Their job is to handle financial obligations so that patients and physicians can focus on healthcare.


  • Communicate with patients and insurance companies regarding eligibility and coordination of benefits
  • Appropriately document and report payment information
  • Educate patients about payment options/ Sliding Fee Scale
  • Calculate and collect payments appropriately for all patients
  • Negotiate and strategize patient payment arrangements
  • Update patient accounts and balances
  • Follow up on any payments that were missed within 3 days
  • Review schedules weekly/daily to identify the Uninsured and determine eligibility for insurance.
  • Conduct screenings with patients to apply for insurance
  • Collaborate daily with social services team regarding the Uninsured
  • Participates in data gathering for financial reporting
  • Assist, when needed, with assisting patients in switching their primary care providers (PCP).

PHMC Compliance Responsibilities:

  • Understands and adheres to PHMC compliance standards as they appear in the PHMC Code of Conduct, Whistle Blowers and Conflict of Interest Policies.
  • Keeps abreast of all pertinent federal, state and PHMC regulations, laws, and policies as they presently exist and as they change or are modified.
  • Comply with HIPAA and Confidentiality Policies and Procedures as they apply to the job.
  • Comply with Department of Public Health (DPH), The Joint Commission and other accreditation and regulatory agencies standards.
  • Adhere to all PHMC Policies and Procedures.

Job Requirements:

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


  • Medical Terminology certification is preferred
  • Strong organizational skills
  • Proficient with Microsoft Word and Excel
  • Comfort and flexibility working in a fast-paced health environment
  • The ability to sit for most of the workday
  • Strong communication skills


  • Patient Billing and Insurance Specialist must be able to communicate effectively with patients, families, doctors, and insurance providers. Strong customer service is also required. Great customer service experience is preferred.
  • Ability to work independently as well as in a team environment. Must demonstrate sound judgement and initiative.

Education Requirement:

  • High School Diploma or GED required.
  • An Associate or bachelor’s degree from an accredited university is preferred.
  • Medical office experience is a plus.

Physical Demands:

  • Position requires sitting 2/3 of the time, use of hands over 2/3 of the time, use of talking or hearing over 2/3 of the time.

Work Environment:

  • Moderate noise (examples: business office with computers and printers, light traffic).


  • Commensurate with education and experience
  • Grade 14