Medical Billing Specialist - Insurance AR

Position Summary

The Medical Billing Specialist performs insurance A/R collection by following up with assigned insurance carriers, managing appeals, resolving patient and payer inquiries, and ensuring accurate account activity.

Key Responsibilities

• Review patient financial information to verify compliance with payer requirements and correct financial coding.
• Audit claim forms for accuracy and completeness; submit claims through payer portals or direct-entry systems.
• Enter allowances and adjustments based on payer guidelines and department procedures.
• Access payer systems to obtain eligibility, claim status, and processing details.
• Respond to inquiries from patients, payers, agencies, and internal departments.
• Analyze unpaid claims to determine appropriate follow-up action and ensure timely reimbursement.
• Review contract reimbursements for accuracy.
• Contact patients and payers by phone to resolve outstanding account balances.
• Correct account errors and document all actions.
• Prepare written correspondence regarding account concerns.
• Evaluate delinquent accounts and determine the best next steps in accordance with department guidelines.
• Assess patient financial information and recommend payment plans when appropriate.
• Prepare accounts for placement with collection agencies when internal efforts are exhausted.
• Process accounts involving returned mail, bankruptcies, or deceased patients per procedures.
• Post and balance daily remittances; apply allowances and adjustments.
• Resolve credit balances through adjustments or refunds to patients or payers.
• Participate in required educational activities and monthly staff meetings.
• Perform other related duties as assigned.

Knowledge, Skills & Abilities

• Extensive experience in medical insurance billing and follow-up.
• Experience in healthcare accounts receivable/collections (preferred).
• Strong analytical skills and sound judgment.
• Excellent interpersonal, written, and verbal communication skills.
• Persuasive and professional customer service abilities.
• Ability to work independently and prioritize daily tasks effectively.
• Ability to communicate clearly with patients, payers, and internal staff.
• Commitment to maintaining confidentiality and following all HIPAA regulations.
• Ability to represent OSS professionally at all times.

Benefits

OSS offers a comprehensive benefits package, including:

• 401(k) with employer match
• Medical, dental, and vision insurance
• Advancement opportunities
• Company-wide celebrations and events

Schedule

Monday–Friday, 8:00 a.m. – 5:00 p.m.

Equal Opportunity Employer

OSS does not discriminate based on race, color, religion, national origin, gender, gender identity or expression, sexual orientation, age, disability (visible or invisible), veteran status, genetic information, marital status, or any other protected characteristic.