Medical Billing Specialist

Job Description

We are seeking a skilled Medical Billing Specialist to manage the complete medical billing cycle from patient registration through final payment and collections. This role requires comprehensive knowledge of medical coding, claims processing, and payer requirements. The ideal candidate ensures accurate and timely billing and helps optimize revenue cycle performance. Responsibilities Patient Registration & Insurance Verification: Accurately input patient demographics and insurance information. Verify insurance eligibility and benefits prior to services. Charge Entry: Review provider documentation and assign appropriate CPT, ICD-10, and HCPCS codes. Ensure all services rendered are captured and billed. Claims Submission: Prepare and submit clean claims to insurance companies electronically or by paper. Monitor claim batches and address transmission errors. Payment Posting: Post payments from insurance payers and patients. Reconcile explanation of benefits (EOBs) and patient accounts. Denial Management & Follow-Up: Review and analyze denied or rejected claims. Correct and resubmit claims or initiate appeals as needed. Follow up on outstanding claims and ensure timely reimbursements. Patient Billing & Collections: Generate patient statements and respond to billing inquiries. Set up payment plans and follow up on overdue balances. Collaborate with collections agencies when appropriate. Compliance & Reporting: Maintain HIPAA and regulatory compliance. Produce reports on accounts receivable, billing trends, and payer performance. Stay current with insurance guidelines and billing regulations. Qualifications High school diploma or equivalent required. Associate degree in healthcare administration, accounting, or a related field preferred. Completion of a medical billing and coding certification program. Minimum of 2 years of hands-on experience in full-cycle medical billing. Experience with billing across multiple payer types (Medicare, Medicaid, commercial insurance, workers' comp). Proven experience in claim submission, denial management, AR follow-up, and collections. Show more Show less