Medical Billing Specialist
About The Position
As a Medical Insurance Billing Specialist , you play a vital role in ensuring the financial accuracy and efficiency of our cardiology billing operations. This role focuses on insurance claim management, denial resolution, and tracking reimbursement patterns to ensure claims are processed correctly and promptly. You will work closely with insurance companies, internal departments, and the broader business office team to resolve billing issues, analyze claim trends, and ensure compliance with healthcare billing standards. Your work directly supports the financial sustainability of our clinics and helps ensure patients receive uninterrupted care.
Requirements
- High School Diploma or GED
- Minimum 1 year of healthcare experience
- Minimum 1 year of experience processing health insurance claims
- Understanding of CMS-1500 claim forms, coordination of benefits (COB), PHI, and medical terminology
- Experience using insurance payer websites to verify eligibility and claim status
- Strong organizational and time-management skills
- Detail-oriented with a high commitment to accuracy
- Strong communication skills for working with insurance companies and internal teams
Responsibilities
- Claims Management
- Contact insurance companies to verify claim status and request reprocessing when needed
- Submit and track insurance appeals and corrected claims
- Review and analyze aging reports to resolve outstanding claims
- Denial Analysis & Resolution
- Investigate insurance denials and determine appropriate corrective action
- Identify denial patterns and report trends to improve billing processes
- Coordinate with internal staff to resolve billing discrepancies
- Billing Operations
- Prepare, audit, and submit claims to primary and secondary payers
- Ensure accurate payment postings and balance allocations
- Adjust claims according to established billing procedures
- Communication & Compliance
- Participate in business office phone rotations to support inquiries from patients and external partners
- Maintain strict compliance with HIPAA when handling patient financial information
- Document all account activity and claim updates thoroughly in billing systems
Benefits
- Medical, dental, and vision coverage
- Retirement benefits
- Paid time off
- Competitive compensation
- Tuition Assistance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
