Billing Specialist Jobs

About The Position

Requirements

• High school diploma or equivalent required
• 2+ years of experience in medical billing, with a focus on professional billing and accounts receivable follow-up.
• Solid understanding of CPT, HCPCS, and ICD-10 coding systems and their application in claim submission and reimbursement.
• Experience working with electronic billing systems and payer portals to manage claim status, denials, and appeals.
• Familiarity with insurance reimbursement methodologies, claim adjudication processes, and payer-specific requirements.
• Working knowledge of medical terminology and healthcare documentation.
• Strong analytical and problem-solving skills with the ability to identify issues, evaluate alternatives, and implement solutions.
• Excellent written and verbal communication skills, with the ability to collaborate effectively across teams and with external contacts.
• High attention to detail and accuracy, with proven ability to manage multiple tasks and meet deadlines in a fast-paced environment.

Nice To Haves

• associate’s degree in healthcare administration, Business, or a related field preferred.

Responsibilities

• Work unpaid and partially paid insurance claims to resolve outstanding balances and secure accurate reimbursement in accordance with payer guidelines.
• Research claim status by utilizing insurance portals, conducting phone outreach, and drafting written correspondence as needed.
• Analyze denied or underpaid claims to identify root causes, trends, and necessary corrective actions.
• Submit timely and well-documented appeals for denied claims in alignment with specific payer policies and appeal procedures.
• Resubmit corrected claims with updated coding, documentation, or demographic information to facilitate proper adjudication.
• Maintain thorough and accurate records of all claim follow-up activities within the billing or revenue cycle management system.
• Collaborate with coding teams, clinical documentation specialists, and provider offices to gather missing information or resolve claim discrepancies.
• Monitor aging accounts and prioritize claims based on timely filing limits and payer response windows.
• Identify systemic issues or process inefficiencies impacting claim resolution and escalate concerns to management with supporting documentation.
• Meet or exceed established productivity and quality benchmarks while adhering to compliance and privacy standards.
• Other duties as assigned.

Benefits

• Medical, Dental, Vision benefits
• 401K with employer match
• Paid Time Off, Paid Holidays, Paid Parental Leave, Sabbatical Program