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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.
Job Responsibility
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
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
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
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
Requirements
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