Billing Specialist

We are looking for a motivated and detail-oriented onsite-only Billing Specialist to join our growing team. This role is essential in ensuring the accuracy, efficiency, and timeliness of our medical billing operations.

Responsibilities

• Prepare, review, and submit accurate claims to commercial insurance payers (electronic and paper).
• Ensure proper use of ICD-10, CPT codes, and modifiers during charge entry.
• Monitor claim status and proactively follow up on unpaid or delayed claims.
• Identify and resolve claim rejections and denials in a timely manner.
• Maintain detailed documentation of all billing activity and account updates.
• Post payments, adjustments, and reconcile accounts receivable balances.
• Investigate and resolve outstanding balances, focusing on claims over 60 days old.
• Work with patients to set up payment plans and resolve billing inquiries.
• Collaborate with payers and internal teams to resolve discrepancies.
• Ensure all billing practices comply with HIPAA and applicable federal, state, and local regulations.
• Maintain accuracy in billing records and internal controls.
• Support internal and external audits by providing necessary documentation.
• Stay up to date with payer rules and billing guidelines.
• Communicate effectively with providers, clinic staff, and leadership regarding billing issues.
• Partner with internal departments to ensure all billable services are captured.
• Participate in team meetings, training sessions, and cross-functional initiatives.
• Provide clear updates and accountability on assigned tasks and accounts.
• Identify inefficiencies or recurring issues and recommend solutions.
• Contribute to improving workflows, reducing turnaround times, and increasing accuracy.
• Support implementation of new billing processes, tools, or systems.

Requirements

• Previous medical billing experience (required).
• Strong understanding of claims processing and denial management.
• Excellent attention to detail and accuracy.
• Ability to manage multiple tasks and meet deadlines.
• Strong verbal and written communication skills.
• Ability to work both independently and within a team.

Preferred Qualifications

• Experience with commercial insurance payers.
• Familiarity with billing software systems.
• Knowledge of healthcare revenue cycle processes.

Qualifications

High School Diploma or GED required. 1+ year of medical billing experience preferred (or equivalent combination of training and experience).