Park West Health System Is Hiring A Bilingual Insurance And Billing Specialist

Join our team as an Insurance & Billing Specialist, where you will play a vital role in supporting patient access to care through insurance verification, enrollment assistance, and accurate billing processes. This position offers a great opportunity to make a meaningful impact in a healthcare setting while working collaboratively with diverse teams. 🚑💼

Position Summary

The Insurance & Billing Specialist supports patients and internal staff by verifying insurance coverage, assisting with enrollment, navigating coverage details, and managing billing-related activities. Your focus will be on ensuring precise insurance verification, facilitating enrollment and renewal, and resolving coverage and claim issues. This role is essential in improving access to care and maintaining efficient operational workflows in collaboration with clinical, front desk, and revenue cycle teams. 🤝

Essential Functions

Insurance Eligibility & Coverage Support

• Verify and document patient insurance coverage, benefits, and eligibility within the EMR and payer systems.
• Assist patients with insurance applications, renewals, and updates via Maryland Health Connection and other platforms.
• Provide education to patients regarding insurance coverage, documentation requirements, and next steps.
• Support enrollment, plan selection, and coverage changes for Medicaid, MCHP, and other programs.
• Troubleshoot and escalate complex insurance issues as needed.
• Collaborate with billing and front desk teams to address insurance discrepancies affecting claims and reimbursements.
• Review patient accounts for accuracy of payer information and financial assistance status.
• Assist in obtaining authorizations and required documentation.
• Support denial prevention by maintaining accurate insurance and sliding fee data.

Sliding Fee Discount Program Administration

• Administer the Sliding Fee Discount Program in compliance with federal and organizational standards.
• Review income and household documentation to determine eligibility and appropriate discounts.

General Duties

• Ensure timely completion of applications, renewals, and document submissions.
• Maintain accurate records and proper application of discounts in EMR and billing systems.
• Educate patients about program requirements, renewal timelines, and documentation.
• Document all activities accurately in the EMR and Maryland Health Connection portal.
• Ensure compliance with payer guidelines, program requirements, policies, and regulations.
• Safeguard patient information in accordance with HIPAA and privacy standards. 🔒
• Provide professional, patient-centered service both in person and over the phone.
• Collaborate with clinical and administrative teams to support access and financial workflows.
• Participate in training sessions and departmental meetings.
• Perform any other duties necessary to support operational needs.

Core Responsibilities & Organizational Expectations

Beyond role-specific tasks, all employees are expected to:

• Deliver courteous, responsive, and service-oriented support to patients, visitors, and colleagues. 😊
• Uphold Park West Health System's mission, vision, and values by demonstrating commitment to quality care and respect.
• Follow all applicable federal, state, and organizational policies, including HIPAA, privacy, and security standards.
• Adhere to infection control, safety, and risk management protocols. 🧴🛡️
• Maintain professionalism, reliability, and accountability in attendance, performance, and communication.
• Participate in continuous improvement initiatives, trainings, staff meetings, and organizational projects.
• Perform other relevant duties as assigned.

Qualifications

• High school diploma or equivalent required; Associate degree in healthcare administration, business, or related field preferred.
• Certified Application Counselor (CAC) certification required.
• At least 2 years of experience in healthcare insurance, eligibility, billing, or financial counseling.
• Strong knowledge of Medicaid, Medicare, and commercial insurance plans.
• Experience with electronic medical records and payer portals.
• Bilingual in English and Spanish is required.
• Experience working in a Federally Qualified Health Center (FQHC) environment preferred.
• Experience administering a Sliding Fee Discount Program.
• Must obtain and maintain authorization as an Application Counselor through Maryland Health Connection, including ongoing training and compliance.

Skills & Competencies

• Deep understanding of insurance eligibility, enrollment, and financial assistance processes.
• Knowledge of Sliding Fee Discount Program standards and documentation.
• Familiarity with medical billing workflows and payer requirements.
• Exceptional attention to detail and organizational skills.
• Ability to manage multiple priorities and meet deadlines effectively.
• Strong customer service and communication abilities.
• Problem-solving skills for navigating complex insurance and financial scenarios.
• Proficiency in Microsoft Office Suite and EMR systems.
• Capacity to work independently and collaboratively in a fast-paced healthcare environment. 🚀