Medical Billing Specialist
About the role
We seeking a highly motivated, detail-oriented, and experienced Medical Billing & Collections Specialist to join our growing team in Freehold, New Jersey. We are looking for a knowledgeable professional with a strong background in medical insurance billing, accounts receivable management, insurance collections, and reimbursement recovery. The ideal candidate will have extensive hands-on experience working with commercial insurance carriers, resolving complex claim denials, managing outstanding receivables, and maximizing reimbursement for healthcare providers. Experience with both in-network and out-of-network insurance claims is highly desirable. This position requires an individual who is organized, dependable, analytical, and capable of independently investigating and resolving complicated insurance billing issues.
We are seeking a professional who goes beyond routine claim submission and understands the importance of effective insurance follow-up, reimbursement accuracy, and successful collection outcomes. The successful candidate will demonstrate initiative, accountability, attention to detail, and a commitment to delivering exceptional billing and collections services. Focused Billing & Collection LLC is looking for dedicated professionals who take pride in their work and are committed to achieving excellent results.
Responsibilities
- Manage medical insurance claims throughout the complete revenue cycle, from submission through final reimbursement.
- Perform consistent and thorough insurance accounts receivable follow-up.
- Investigate and resolve denied, rejected, delayed, and underpaid claims.
- Prepare and submit corrected claims, reconsiderations, and formal insurance appeals.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) for payment accuracy.
- Identify reimbursement discrepancies and pursue appropriate payment recovery.
- Communicate effectively with insurance carriers, claims representatives, and healthcare providers.
- Research insurance policies, billing guidelines, reimbursement methodologies, and payer requirements.
- Handle in-network and out-of-network claims, including complex reimbursement issues.
- Maintain accurate and detailed documentation of claim activity, appeals, and collection efforts.
- Monitor aging reports, prioritize outstanding balances, and support timely reimbursement.
- Maintain compliance with HIPAA and applicable healthcare billing regulations.
Requirements
- 3-5 years of medical billing and insurance collections experience preferred.
- Strong knowledge of commercial insurance billing and revenue cycle management.
- Demonstrated experience in insurance A/R follow-up, denial resolution, and collections.
- Ability to interpret EOBs, ERAs, CPT codes, ICD-10 codes, and reimbursement information.
- Experience with medical billing software, insurance payer portals, and Microsoft Excel.
- Excellent verbal and written communication skills.
- Strong analytical, organizational, and problem-solving abilities.
- Ability to work independently, manage priorities, and maintain accuracy in a fast-paced environment.
- Experience with out-of-network insurance claims and reimbursement recovery.
- Knowledge of self-funded insurance plans and ERISA-related claim processes.
- Experience preparing detailed insurance appeals and reconsiderations.
- Physical therapy and chiropractic billing experience.
- Experience working for a third-party medical billing or revenue cycle management company.
- Familiarity with insurance payment negotiations and underpayment resolution.
- Medical billing: 3 years required.
Pay
$23.00 - $25.00 per hour
Schedule
Full-time, in-office position in Freehold, New Jersey.