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AP
Medical Billing Specialist
Appalachian State UniversityUnited Statesfull_timeVerifiedPosted 15 Jul 2026
💰 $50,530/yr($48,004/yr – $50,530/yr)
About the role
Position Summary Information
Classification Title
University Program Associate
Working Title
Medical Billing Specialist
Location
Boone, NC
Job Category
5
Position Number
062941
Not Eligible for Visa Sponsorship
VISA sponsorship is not available for this position. All candidates must be eligible to work and live in the U.S
Department
Appalachian Institute for Health and Wellness - 273600
Primary Purpose of Position
To execute all billing and credentialing for all AppWell clinic facilities.
- Claims Submission: Prepare, review, and transmit claims to insurance companies(commercial and government) for reimbursement.
- Revenue Cycle Management: Monitor claim status, follow up on unpaid claims, and appeal denied claims to ensure timely payment.
- Patient Billing: Calculate patient responsibility, send patient statements, and handle inquiries about bills.
- Compliance: Adhere to HIPAA regulations to maintain patient confidentiality and comply with all legal/payer requirements. Provide front desk back up support to the LLHS Clinic Front Desk as needed. Be available to train student interns, graduate assistants, and student employees as appropriate. Serve as a mentor modeling professional behavior. Execute Insurance provider enrollment processes and set up. Execute Initial setup and maintenance of credentialing for all affiliated providers. Update and maintain all CAQH Provider Profiles. Proper use and assignment of billing codes.
- Knowledge of HIPAA regulations. Stay up to date on appropriate billing codes and procedures. Balance end of day according to clinic policies and procedures. Track payments from all sources including Touchnet, Clover, Zealous, Availity, WayStar, (and others) as well as Student Accounts. Obtain prior authorizations as needed for allied health provider services.
Bachelor’s degree; or equivalent combination of training and experience. All degrees must be received from appropriately accredited institutions.
License/Certification Required
Essential Job Functions
The Medical Billing Specialist conducts all billing services for the AppWell Clinic and act as the electronic health records administrator. This role:
- provides clients with a written/and/or verbal determination of fees for all clinical services (evaluation, screening, therapy, etc.
- establishes and monitors accounts payable and receivable for all clients
- is responsible for all insurance processes such as patient benefit inquiries, prior approval processes and physician referral requests
- submits insurance claims by standard or electronic methods
- updates, monitors & follow-ups all electronic & paper claims
- monitors delays and denials of claims and prior approval requests.
- assists with data collection for statistical reports.
This role has extensive phone & e-mail contact with Medicaid, Medicare, BCBS of NC, other healthcare plans, state & local agencies including CDSA. They will be responsible for insurance provider enrollment process and set-up.
Secondary responsibilities include assisting office staff, students and clinical faculty with routine and complex office procedures, including electronic health records. Assisting with public inquiries about clinical services and fees, client scheduling, policies & taking referral information. Conducting client file reviews and audits. Updating additions and/or deletions to the clinic materials database. Ordering of clinic diagnostic / therapy test materials and forms.
- Knowledge of Electronic Health Records and billing policies and insurance guidelines for multiple insurance agencies.
- Must be able to oversee all insurance processes including benefit inquires, prior approvals, and physician referrals.
- Update and monitor electronic and paper claims.
- Ensure insurance provider enrollment process and set up.
- Work with Electronic Health Records and oversee implementation of electronic billing process. Proper use and assignment of billing codes.
- Knowledge of HIPAA regulations.
- Basic office skills, supervisory skills and the ability to produce and evaluate data
- Ability to work independently and without instruction, to handle pressures, to prioritize work and stay focused in a busy environment, to make administrative decisions, to be patient and flexible in a demanding environment, and to provide instruction and oversight for
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