Medical Billing Specialist

Responsibilities

• Examine service records, authorizations, care plans, and supporting documents to confirm claims are ready for submission to Minnesota Medical Assistance and other applicable payers.
• Process and track claims for home care and related community-based services using payer portals, clearinghouses, and revenue cycle platforms.
• Investigate unpaid, denied, rejected, underpaid, or recouped claims and take appropriate action to secure correct reimbursement.
• Conduct account reviews for aged receivables, including outstanding balances over 30 days, and document follow-up activity in assigned tracking tools.
• Analyze remittance information to identify payment variances, denials, adjustments, spend-down impacts, and reimbursement discrepancies.
• Resolve billing exceptions by correcting claim details and submitting original, replacement, corrected, or voided claims in line with payer rules.
• Review unbilled service lines regularly to ensure eligible charges are captured and submitted without unnecessary delay.
• Respond to billing-related questions from internal teams and external partners, including payers, case managers, coordinators, and other stakeholders.
• Maintain compliance with state and federal billing standards, documentation expectations, coding requirements, confidentiality obligations, and fraud prevention guidelines.
• Escalate high-risk account concerns, authorization mismatches, documentation deficiencies, database inaccuracies, and payer-related barriers to leadership when needed.

Requirements

• Experience in medical billing, claims processing, or healthcare revenue cycle operations.
• Working knowledge of insurance billing practices, remittance review, and denial resolution.
• Familiarity with computerized billing systems, clearinghouses, and online payer portals.
• Strong attention to detail with the ability to verify documentation, authorizations, and coding accuracy.
• Effective written and verbal communication skills for handling billing inquiries and coordinating with internal and external contacts.
• Ability to organize workload, prioritize follow-up tasks, and meet productivity goals in a deadline-driven environment.
• Understanding of confidentiality standards and compliance expectations within a healthcare setting.

Qualifications

• High school diploma or equivalent.
• Associate's degree in healthcare, business administration, or a related field preferred.
• Minimum of 2 years of relevant experience in medical billing, claims processing, or healthcare revenue cycle operations.

Skills

• Medical billing and claims processing.
• Insurance billing practices and remittance review.
• Computerized billing systems and online payer portals.
• Attention to detail and verification of documentation.
• Effective communication and coordination skills.
• Deadline-driven work environment.
• Confidentiality and compliance standards in healthcare.

Benefits

• Medical, vision, dental, and life and disability insurance.
• Access to top jobs, competitive compensation, and benefits.
• Free online training.
• Company 401(k) plan eligibility.

Pay

Competitive salary based on experience and qualifications.

Schedule

Full-time position.