MEDICAL BILLING SPECIALIST

• Accurately process and submit medical claims using proper coding
• Review and verify patient information, insurance eligibility, and coverage.
• Submit and track claims to insurance companies and third-party payers.
• Follow up on unpaid or denied claims, resolving billing issues and discrepancies promptly.
• Work closely with the coding department to ensure accurate and compliant claims submissions.
• Assist patients by explaining billing processes, payment options, and account balances.
• Process patient payments and insurance payments and apply them to the appropriate accounts.
• Handle appeals and re-submissions for denied or underpaid claims.
• Maintain accurate records of billing transactions, payment postings, and account adjustments.
• Generate and analyze reports on billing, collections, and accounts receivable to ensure revenue optimization.
• Collaborate with providers, insurance representatives, and billing staff to streamline the billing process and resolve issues.
• Stay up-to-date with changes in insurance policies, coding requirements, and healthcare regulations.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Health Information Management, Accounting, or a related field required.
• Knowledge of ICD-10, CPT, and HCPCS coding systems, as well as healthcare reimbursement practices.
• Strong understanding of insurance claims processing and healthcare regulations.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently with attention to detail in a high-volume setting.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook)

Education & Experience:

• Bachelor’s degree in Healthcare Administration, Health Information Management, or a related field required.
• A minimum of 2-3 years of experience in medical billing, coding, or healthcare revenue cycle management.

Key Responsibilities:

Accurately process and submit medical claims using proper coding

Review and verify patient information, insurance eligibility, and coverage.

Submit and track claims to insurance companies and third-party payers.

Follow up on unpaid or denied claims, resolving billing issues and discrepancies promptly.

Work closely with the coding department to ensure accurate and compliant claims submissions.

Assist patients by explaining billing processes, payment options, and account balances.

Process patient payments and insurance payments and apply them to the appropriate accounts.

Handle appeals and re-submissions for denied or underpaid claims.

Maintain accurate records of billing transactions, payment postings, and account adjustments.

Generate and analyze reports on billing, collections, and accounts receivable to ensure revenue optimization.

Collaborate with providers, insurance representatives, and billing staff to streamline the billing process and resolve issues.

Stay up-to-date with changes in insurance policies, coding requirements, and healthcare regulations.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Health Information Management, Accounting, or a related field required.
• Knowledge of ICD-10, CPT, and HCPCS coding systems, as well as healthcare reimbursement practices.
• Strong understanding of insurance claims processing and healthcare regulations.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently with attention to detail in a high-volume setting.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook)

Education & Experience:

• Bachelor’s degree in Healthcare Administration, Health Information Management, or a related field required.
• A minimum of 2-3 years of experience in medical billing, coding, or healthcare revenue cycle management.