Medical Billing Specialist (Remote)

Responsibilities

• Prepare and submit claims accurately and efficiently in accordance with payer guidelines
• Review and resolve rejected or denied claims, ensuring timely resubmission
• Investigate and resolve unbilled accounts to prevent revenue leakage and delays in claim generation
• Analyze rejection patterns and identify trends to detect potential systemic issues
• Collaborate with internal teams to address root causes and improve billing accuracy
• Elevate unresolved or complex billing issues to leadership or payer representatives as appropriate
• Maintain current knowledge of payer requirements and billing regulations
• Support continuous improvement initiatives within the billing and revenue cycle operations

Qualifications

• A high school diploma or equivalent required
• 3+ years of experience in medical billing, medical claims, or healthcare revenue cycle, or payer claims required
• Home health, Medicaid, managed care, or pediatric healthcare billing experience preferred
• Familiarity with HHAX, Waystar, and Availity preferred