Billing Specialist

TEKsystems•Bountiful, UT

2d•$22 - $25•Onsite

About The Position

The Medical Billing Specialist is responsible for managing the full revenue cycle process, including claims submission, denial resolution, accounts receivable follow-up, appeals, and insurance billing activities for assigned healthcare locations. This role works closely with clinical, administrative, and revenue cycle teams to ensure accurate claim processing, timely reimbursement, and effective resolution of billing issues. The ideal candidate brings a strong foundation in healthcare billing and can quickly contribute with minimal training on billing fundamentals, while learning internal systems and processes. Success in this role requires strong analytical abilities, attention to detail, initiative, and a commitment to delivering excellent customer service.

Requirements

2-3 years of healthcare billing experience required.
Demonstrated experience with claims processing, denial management, insurance verification, and accounts receivable follow-up.
Strong understanding of medical billing fundamentals and healthcare reimbursement processes.
Ability to quickly contribute with minimal training on core billing functions and concepts.
Experience researching and resolving denied, rejected, or unpaid claims.
Working knowledge of EMR systems and medical billing software.
Familiarity with clearinghouse platforms; experience with TriZetto or similar systems preferred.
Strong accounts receivable and collections experience.
Knowledge of claim appeals, payment posting, and revenue cycle management best practices.
Excellent problem-solving and analytical skills with strong attention to detail.
Self-motivated and able to work independently while managing multiple priorities.
Strong verbal and written communication skills.
Exceptional customer service skills and professionalism in all interactions.
Proficiency with Microsoft Office Suite, including Outlook, Word, and Excel.
Ability to identify process improvement opportunities and contribute to operational efficiencies.
Must be able to work fully onsite in the Woodcross, UT area.

Nice To Haves

Experience with TriZetto or similar systems preferred.

Responsibilities

Review, validate, and submit clean claims to insurance payers electronically and via paper submission as required.
Monitor claim acceptance and proactively resolve claim rejections to ensure timely reimbursement.
Research, investigate, and resolve denied claims, including claim corrections, resubmissions, and appeals.
Interpret and analyze Explanation of Benefits (EOBs) and payer communications to identify payment discrepancies and denial trends.
Conduct accounts receivable follow-up activities and take timely action on unpaid or underpaid claims.
Review claims through EMR and clearinghouse systems to identify billing edits and ensure claim accuracy prior to submission.
Collaborate with office staff, clinical teams, and revenue cycle personnel to resolve issues impacting billing accuracy and reimbursement timelines.
Investigate accounts receivable aging reports and manage outstanding balances for assigned office locations.
Resolve disputed balances and billing discrepancies within billing and EMR systems.
Prepare and submit insurance appeals with appropriate documentation to maximize reimbursement opportunities.
Assist in identifying workflow improvements that enhance billing efficiency, claim accuracy, and overall revenue cycle performance.
Support management and training initiatives by providing guidance on billing, collections, denial management, and account resolution processes.
Perform monthly variance analysis for assigned locations and communicate trends or concerns to leadership.
Maintain detailed documentation of billing activities, account statuses, and follow-up actions.
Respond professionally to patient, payer, and internal inquiries while providing excellent customer service.
Partner with supervisors and revenue cycle leadership to identify compliance concerns, billing issues, and emerging accounts receivable trends.