Medical Billing Representative

Responsibilities

• Medical Billing Expertise: Proficient in billing, claims processing (Inpatient, Outpatient, Critical Access, Rural Health), denials management, and knowledge of medical terminology, physician fee schedules, DRGs, and reimbursement procedures.
• Claims and Appeals Processing: Submits and follows up on insurance claims; resolves denials and rejections; prepares appeal letters with proper documentation and cross-department coordination.
• Account Management & Collections: Retrieves and updates patient account statuses, processes remittances, manages A/R, ensures accurate charge entry, and performs financial analysis to support revenue goals.
• Communication & Customer Service: Answers patient and payer inquiries, verifies insurance eligibility and authorizations, documents account activity, and maintains confidentiality in compliance with HIPAA.
• Operational Efficiency: Utilizes EMR systems, adheres to productivity benchmarks, meets deadlines, and demonstrates strong organizational, multitasking, and communication skills.

Requirements

• Bachelor’s degree in healthcare or business administration.
• Experience in medical billing and denials, customer service and relevant finance experience in a health care organization (preferred).
• Certification in medical billing (Union CSEA (MH) preferred).

Qualifications

Preferred Qualifications:

• Bachelor’s degree in healthcare or business administration.
• Experience in medical billing and denials, customer service and relevant finance experience in a health care organization.
• Certification in medical billing (Union CSEA (MH) preferred).

Skills

Skills:

• Proficient in billing, claims processing, denials management, and medical terminology.
• Knowledge of physician fee schedules, DRGs, and reimbursement procedures.
• Ability to resolve denials and prepare appeal letters.
• Experience in account management and collections.
• Strong communication and customer service skills.
• Utilization of EMR systems and adherence to productivity benchmarks.
• Organizational, multitasking, and communication skills.

Benefits

Not specified.

Pay

$20.26 - $29.40

Schedule

8a-4p (Mon-Fri)