Medical Billing Specialist Jobs

About The Position

Requirements

• A solid understanding of medical and billing terminology
• Experience managing denied claims and performing denial management
• Familiarity with UB‑04 and CMS‑1500 claim forms
• Experience interacting with representatives from various health plans
• Ability to interpret Explanation of Benefits (EOBs) to assess proper reimbursement
• Knowledge of billing codes
• High School Diploma or General Education Degree (GED)
• Proficiently uses a computer, keyboard, and calculator
• Excellent oral and written communication skills

Nice To Haves

• 2 years of billing experience preferred
• 1 year of medical billing experience ideal

Responsibilities

• Correct, complete, and process claims for all payors according to established standards
• Perform follow‑up with payors on unpaid accounts identified through aging reports, denials, or payer rejections
• Demonstrate thorough knowledge of billing policies and procedures, including editing, denial management, and appeal processing
• Process appeals online or via paper submission, acting as a liaison between healthcare providers and insurance companies to complete appeals, reconsiderations, and corrected claims in a timely manner according to payer contracts
• Collaborate with internal departments to ensure proper billing of claims, reduce denials, and support billing audits as needed
• Answer and respond to correspondence, calls, and concerns related to patient accounts
• Remain current with all regulatory requirements related to billing and adhere to HIPAA regulations and patient confidentiality
• Accurately review payor contracts to ensure appropriate reimbursement
• Review and initiate refund requests as appropriate