Medical Billing Specialist

Location: Winston-Salem, NC • Pay: $25/hour • Full-time, direct hire • Schedule: Monday - Friday, 8:00am to 5:00pm

About the role

The Medical Billing Specialist ensures timely and accurate billing, payment posting, claim follow-up, and collection of patient and insurance accounts. This individual will work closely with physicians, clinical staff, front office personnel, and insurance companies to maximize reimbursement while maintaining exceptional customer service and compliance with all regulatory requirements.

Responsibilities

• Insurance Claims Management
  • Submit clean electronic and paper claims in a timely manner.
  • Review claims for accuracy prior to submission.
  • Correct claim errors and resubmit denied or rejected claims.
  • Monitor claim status until final payment is received.
  • Identify trends in denials and recommend corrective actions.
• Accounts Receivable Management
  • Follow up on unpaid insurance claims according to established aging guidelines.
  • Contact insurance carriers regarding claim status, payment delays, and denials.
  • Appeal denied claims with appropriate documentation.
  • Maintain assigned A/R aging within departmental goals.
• Payment Posting
  • Accurately post insurance and patient payments.
  • Reconcile electronic remittance advice (ERA) and explanation of benefits (EOBs).
  • Identify payment discrepancies and underpayments.
  • Process adjustments according to company policy.
• Patient Account Management
  • Review patient balances for accuracy.
  • Answer billing questions from patients professionally and courteously.
  • Assist patients in understanding insurance benefits and financial responsibility.
  • Coordinate payment arrangements when appropriate.
• Reporting and Productivity
  • Maintain daily productivity standards.
  • Document all collection activities thoroughly.
  • Prepare reports on assigned accounts.
  • Meet monthly collection and account resolution goals.
• Compliance
  • Maintain HIPAA compliance at all times.
  • Follow payer regulations and billing guidelines.
  • Adhere to the commercial insurance requirements.
  • Protect confidential patient information.

Requirements

• 2 years of medical billing experience required.
• Fertility, OB/GYN, or specialty practice billing experience strongly preferred.
• High school diploma or GED required.
• Associate degree in Business, Healthcare Administration, or related field preferred.
• Certified Professional Biller (CPB) or equivalent certification preferred.
• Strong understanding of medical billing and revenue cycle management.
• Knowledge of CPT, ICD-10, and HCPCS coding.
• Understanding of insurance contracts and reimbursement methodologies.
• Excellent problem-solving and analytical skills.
• Strong organizational and time-management abilities.
• High attention to detail and accuracy.
• Excellent written and verbal communication skills.
• Ability to work independently while collaborating with a team.
• Proficiency in Microsoft Office, particularly Excel and Outlook.

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• LTD, STD, 401k, profit sharing