Insurance Billing Specialist

TEKsystems•Happy Valley, OR

5d•$25 - $30•Remote

About The Position

We are seeking a detail-oriented and driven Insurance Billing Specialist to join our remote team. In this role, you will be responsible for processing, submitting, and following up on insurance claims to ensure timely and accurate reimbursement. You’ll work closely with internal clinical teams and external payers while representing our core values every day.

Requirements

High school diploma required; Associate’s degree in Healthcare Administration, Medical Billing, or a related field preferred.
2+ years of medical billing experience, including direct experience with Medicare, MVA, and Workers’ Compensation claims.
Strong knowledge of medical terminology and coding systems (CPT, ICD-10-CM, HCPCS).
Proficiency with medical billing software, EHR systems, and insurance payer portals.
Solid understanding of insurance verification, coverage guidelines, and pre-service eligibility checks.
Excellent analytical, problem-solving, and organizational skills with strong attention to detail.
Clear and professional written and verbal communication skills.
Ability to work independently, manage multiple priorities, and meet deadlines in a fast-paced environment.

Nice To Haves

Certified Medical Billing Specialist (CMBS) or similar certification preferred.

Responsibilities

Process and submit clean, accurate insurance claims to Medicare, Motor Vehicle Accident (MVA), Workers’ Compensation, and other commercial payers in compliance with payer-specific requirements.
Perform thorough follow-up on unpaid, denied, or rejected claims to maximize reimbursement and resolve outstanding balances.
Research, analyze, and resolve claim denials by identifying root causes and implementing corrective actions, including preparing and submitting timely appeals when needed.
Verify patient insurance coverage and benefits prior to service to ensure eligibility and accurate billing.
Maintain detailed and accurate documentation of billing activities, claim statuses, and payer communications.
Monitor and manage aging reports, prioritizing follow-up based on claim age, payer responsiveness, and filing deadlines.
Navigate payer portals and systems to check claim status, update information, and facilitate payment resolution.
Communicate professionally with insurance representatives to clarify policies, address payment issues, and negotiate resolutions.
Collaborate with clinical teams and providers to obtain additional documentation or correct coding as needed to support claims.
Stay current on insurance billing regulations, payer guidelines, and coding updates to ensure compliance and optimal reimbursement.
Perform other duties as assigned.