We are seeking a dedicated and detail-oriented Medical Billing Specialist to join our team. The ideal candidate will have a strong background in medical billing and collections, with a deep understanding of insurance procedures, claim management, and accounts receivable processes. As a key member of our billing department, you will be responsible for managing the billing cycle, resolving claims issues, and ensuring timely payments for medical services provided.

Responsibilities:

• Billing & Coding: Accurately review and submit medical claims to insurance companies, government programs (e.g., Medicare, Medicaid), and patients based on services provided.
• Accounts Receivable Management: Monitor and follow up on unpaid claims and accounts, ensuring timely resolution and payment collection.
• Claim Denial Management: Investigate and resolve denied or rejected claims, working with insurance providers to rectify issues and ensure proper reimbursement.
• Payment Posting: Post payments, adjustments, and denials to patient accounts accurately.
• Patient Communication: Communicate with patients and insurance companies to resolve billing inquiries, provide payment information, and answer any questions related to their accounts.
• Account Reconciliation: Ensure all accounts are reconciled and balanced, identifying discrepancies and making necessary adjustments.
• Compliance: Maintain up-to-date knowledge of relevant billing codes, insurance policies, and regulations to ensure compliance with industry standards and government regulations.
• Reporting: Generate and review accounts receivable reports, aging reports, and other billing data to ensure financial goals are met and identify areas for improvement.
• Collaboration: Work closely with the clinical and administrative teams to resolve any billing issues, discrepancies, or concerns.

Qualifications:

• High school diploma or equivalent; Associate’s degree in Health Information Technology, Business Administration, or a related field is preferred.
• 1+ years of experience in medical billing and accounts receivable, preferably within a healthcare setting.
• Strong knowledge of medical terminology, coding systems (CPT, ICD-10, HCPCS), and insurance regulations.
• Experience with medical billing software and electronic health records (EHR) systems.
• Excellent communication skills, both verbal and written.
• Detail-oriented with strong organizational and analytical skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Knowledge of HIPAA regulations and confidentiality requirements.