Medical Billing Specialist

Job SummaryWe are seeking a detail-oriented and organized Medical Billing Specialist to manage the billing process for healthcare services. The ideal candidate will ensure accurate claim submission, follow up on unpaid claims, resolve billing discrepancies, and maintain compliance with insurance regulations and healthcare billing standards. This position plays a critical role in optimizing revenue cycle performance and ensuring timely reimbursement.Key ResponsibilitiesPrepare, review, and submit medical claims to insurance companies and government payers.Verify patient insurance coverage and eligibility.Review patient accounts for accuracy and completeness before claim submission.Monitor and track claim status to ensure timely reimbursement.Follow up on denied, rejected, or unpaid claims and initiate appeals when necessary.Post payments, adjustments, and patient payments accurately into the billing system.Communicate with insurance companies, healthcare providers, and patients regarding billing issues.Maintain compliance with HIPAA regulations and payer requirements.Reconcile accounts and resolve billing discrepancies.Generate billing reports and assist with revenue cycle analysis.Keep current with changes in medical coding, billing procedures, and insurance regulations.Assist patients with billing inquiries and payment arrangements.Required QualificationsHigh school diploma or GED required; Associate degree preferred.1-3 years of medical billing experience in a healthcare setting.Knowledge of medical terminology, CPT, ICD-10, and HCPCS coding systems.Experience with electronic health records (EHR) and medical billing software.Understanding of insurance policies, claims processing, and reimbursement procedures.Strong attention to detail and accuracy.Excellent organizational, communication, and problem-solving skills.Proficiency in Microsoft Office, particularly Excel.Preferred QualificationsCertified Professional Biller (CPB) certification preferred.Experience with Medicare, Medicaid, and commercial insurance billing.Knowledge of revenue cycle management best practices.Experience working in physician practices, hospitals, or healthcare organizations.Key CompetenciesAttention to DetailTime ManagementAnalytical ThinkingCustomer ServiceCommunication SkillsConfidentiality and ComplianceProblem ResolutionTeam Collaboration