Medical Billing Specialist

The Medical Billing Specialist is responsible for accurately processing and submitting medical claims, maintaining accounts receivable, resolving billing discrepancies, posting payments, and supporting patient account activities to ensure timely reimbursement and excellent customer service.

Essential Duties & Responsibilities

Medical Billing & Payment Posting

• Submit accurate and timely insurance claims through Practice Management Systems and clearinghouse portals.
• Post insurance, contractual, and patient payments accurately.
• Research and resolve denied, rejected, or missing claims and payments.
• Reconcile payer takebacks and payment discrepancies.
• Balance and post daily deposits within established timelines.
• Maintain accurate documentation of payment activity using Excel spreadsheets.
• Monitor and resolve patient and insurance credit balances.

Accounts Receivable & Follow-Up

• Review and follow up on outstanding insurance claims and aged accounts receivable.
• Verify patient demographics, insurance coverage, and billing information.
• Obtain missing documentation required for claim processing.
• Maintain knowledge of payer guidelines, filing limits, and reimbursement requirements.
• Work with providers, clinical staff, payers, and patients to resolve billing issues.
• Set up patient payment arrangements and respond to billing inquiries.

Credentialing & Administrative Support

• Assist with provider credentialing and re-credentialing applications.
• Maintain provider contracts and credentialing records.
• Track application statuses and follow up with payers as needed.
• Support administrative and reporting functions as assigned.

Coding & Compliance

• Review documentation for coding accuracy and compliance.
• Support CPT and ICD-10 coding processes.
• Assist with audits and documentation reviews.
• Maintain confidentiality and comply with HIPAA and organizational policies.

• High School Diploma or equivalent required.
• 2+ years of medical billing or healthcare revenue cycle experience preferred.
• Experience with insurance claims, payment posting, and accounts receivable follow-up.
• Knowledge of CPT, ICD-10, and medical terminology preferred.
• Strong Microsoft Excel and computer skills.
• Excellent communication, customer service, and organizational abilities.
• Ability to manage multiple priorities in a fast-paced environment.