Job Description

Job Description

Job Description

Medical Billing Specialist - Claims

Hybrid - remote on Friday

We are seeking a detail-oriented and experienced  Medical Billing Claims Specialist to join our healthcare team. This role is responsible for preparing, submitting, and following up on medical claims to ensure accurate and timely reimbursement from insurance companies and patients. The ideal candidate will have strong knowledge of medical billing procedures, coding systems (ICD-10, CPT, HCPCS), and payer requirements.

Key Responsibilities:

• Prepare and submit clean claims to various insurance carriers electronically and by paper.
• Review patient bills for accuracy and completeness; obtain any missing information.
• Follow up on unpaid or denied claims and initiate appeals as necessary.
• Work with insurance companies, healthcare providers, and patients to resolve billing issues.
• Verify patient insurance coverage as needed.
• Post payments and reconcile accounts.
• Maintain accurate and up-to-date billing records and documentation.
• Ensure compliance with HIPAA and other healthcare regulations.

Qualifications:

• Minimum of 2 years of experience in medical billing and claims processing.
• Familiarity with EHR systems (e.g., Epic, Cerner, Kareo) and billing software.
• Strong understanding of insurance guidelines including Medicare, Medicaid, and commercial carriers.
• Knowledge of medical terminology, ICD-10, CPT, and HCPCS codes.
• Excellent communication, organizational, and analytical skills.
• Ability to work independently and meet deadlines.

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