Medical Billing Specialist

Key Responsibilities

• Submit accurate and timely initial claims to payers, ensuring all required information is complete and compliant with billing guidelines.
• Review and research all denied, fully unpaid, or partially paid claims; correct and resubmit claims promptly to appropriate payers or customers.
• Prepare and submit appeals within payer filing limits to prevent claims from progressing to bad debt.
• Identify and analyze preventable denial trends, providing actionable feedback and recommending system improvements or automation opportunities.
• Proactively work select preventable denials to ensure timely resolution and minimize impact to accounts receivable.
• Monitor, review, and resolve exception reports (e.g., rental exceptions), ensuring discrepancies are addressed efficiently.
• Accurately adjust uncollectible accounts using appropriate adjustment codes to support reporting and trend analysis.
• Maintain detailed and accurate documentation of all account activity, billing updates, and collection efforts within the system.
• Ensure all billing changes are properly documented, including updates related to physician orders, insurance changes, and financial assistance applications.
• Respond to written customer and payer inquiries regarding account status within five business days.
• Communicate identified errors, trends, and process gaps to leadership to support continuous improvement.

Qualifications

• High school diploma or equivalent
• 1-3 years of experience in medical billing, accounts receivable, or collections
• Knowledge of payer guidelines, denial management, and appeals processes
• Strong attention to detail and problem-solving skills
• Ability to manage multiple priorities and meet deadlines
• Proficient in Microsoft Office and billing systems

Preferred Qualifications

• Experience with Medicare, Medicaid, and commercial payers
• Knowledge of CPT, HCPCS, and ICD-10 coding
• Experience in DME or healthcare revenue cycle operations
• Experience identifying trends and contributing to process improvements

Benefits

• Health
• Dental
• Vision
• 401K plus match incentive program
• Life insurance
• Paid time off
• Paid holidays
• Long-term disability
• Short-term disability
• Free parking
• Volunteer pay
• Green initiatives

About the Role

Join our dynamic and growing company as an AR Billing/Collections Representative! We are a dedicated and caring organization known for our exceptional products, services, and our mission to enrich lives. This is an exciting opportunity to become part of a dedicated team focused on maintaining strong financial health and building lasting relationships with our customers. Professionals who are seriously searching for a healthy culture should apply! This is a full-time position, Mon-Fri, 8:30 am - 5 pm, on-site. Looking for local candidates!