MEDICAL BILLING SPECIALIST

Twin Med Llc

9h

About The Position

The Medical Billing Specialist plays a critical role in the healthcare revenue cycle by ensuring accurate and timely processing of patient billing information. This position involves managing insurance claims, verifying patient data, and resolving billing discrepancies to maximize reimbursement for healthcare providers. The specialist collaborates closely with medical staff, insurance companies, and patients to facilitate clear communication and efficient billing operations. Attention to detail and compliance with healthcare regulations are essential to maintain the integrity of billing processes and protect patient information. Ultimately, this role contributes to the financial health of the organization by optimizing billing accuracy and minimizing claim denials.

Requirements

• High school diploma or equivalent required
• Proven experience in medical billing or healthcare revenue cycle management.
• Familiarity with medical billing codes (CPT, ICD-10, HCPCS) and insurance claim processes.
• Strong knowledge of HIPAA regulations and patient confidentiality standards.
• Proficiency with medical billing software and electronic health record (EHR) systems.
• Attention to detail is critical when reviewing patient records and insurance information to prevent errors that could delay payments.
• Communication skills are essential for effectively resolving claim denials and clarifying billing questions with various stakeholders.
• Analytical abilities help the specialist identify trends in denied claims and implement corrective actions to improve billing efficiency.
• Knowledge of healthcare regulations ensures compliance and protects patient privacy throughout all billing activities.

Nice To Haves

• associate degree or higher in healthcare administration or related field preferred.
• Certification as a Certified Professional Biller (CPB) or Certified Coding Specialist (CCS).
• Experience working with multiple insurance payers including Medicare and Medicaid.
• Advanced knowledge of healthcare reimbursement methodologies and payer policies.

Responsibilities

• Prepare and submit accurate medical claims to insurance companies and government programs in a timely manner.
• Review patient records and billing information to ensure completeness and accuracy before claim submission.
• Follow up on unpaid or denied claims by communicating with insurance providers and resolving discrepancies.
• Verify patient insurance coverage and eligibility prior to services being rendered.
• Maintain detailed records of billing activities, payments received, and outstanding balances.
• Collaborate with healthcare providers and administrative staff to clarify billing questions and update patient information.
• Ensure compliance with federal, state, and payer-specific regulations and guidelines related to medical billing.
• Utilize billing software and electronic health record (EHR) systems to manage billing workflows efficiently.

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees