Medical Billing Specialist II

About the role

The Medical Billing Specialist II plays a crucial role in the billing and accounts receivable functions, focusing on high-dollar, complex, and special accounts. This role involves managing the entire billing lifecycle, resolving denials and underpayments, performing advanced collections, overseeing payment processing, and collaborating with internal and external stakeholders to ensure accurate and timely reimbursement.

Responsibilities

• Manage the end-to-end billing lifecycle for assigned high-dollar, complex, and Special Accounts, from claim submission through final resolution.
• Monitor and resolve claim denials and underpayments, including analysis of trends and identification of corrective actions.
• Perform advanced collection activities to support timely reimbursement from commercial, Medicaid, Medicare, and private pay sources.
• Oversee payment processing activities by reviewing and reconciling payments, identifying discrepancies, and supporting resolution of payment variances.
• Serve as a point of contact for complex billing matters, working collaboratively with internal departments, providers, patients, and payer representatives.
• Ensure accurate and timely documentation of account activity within billing and revenue cycle systems.
• Maintain compliance with all applicable state, federal, and payer regulations, policies, and standards.
• Utilize billing systems, payer portals, and government billing platforms to manage claims and reimbursement activity.
• Support the Billing Assistant with eligibility verification.

Requirements

This role requires an experienced individual with at least three (3) years of progressively responsible experience in medical billing, accounts receivable, or revenue cycle operations. A bachelor’s degree in accounting, business administration, healthcare administration, or a related field is preferred, along with four (4) or more years of experience in medical and/or behavioral health billing. Prior experience in behavioral health, psychiatric, or specialty medical billing environments, and coursework or formal training in medical and/or psychiatric terminology are also preferred.

Qualifications

• High School Diploma or GED
• Professional certification such as Certified Professional Coder (CPC)

Skills

Knowledge of medical and psychiatric terminology, proficiency in using billing systems, payer portals, and government billing platforms, and strong communication and problem-solving skills are essential for this role.

Benefits

Comprehensive Coverage: Health, Dental & Vision
Generous PTO: Up to 19 days + 2 mental health days + 10 holidays (pro-rated for part-time)
Fully Paid YMCA Membership for you and eligible family members
Company-Paid Life & Disability Insurance
Student Loan Assistance & Professional Development
403(b) Retirement Plan with Company Contributions
Employee Assistance Program (EAP)
Pet Insurance
Free Wellness App (2MorrowHealth)
Collaborative, Supportive Team Environment

Pay

Hiring Range: $24.94 – $30.55 per hour

Schedule

Full-Time, On-Site