Medical Billing and Claims Processing Specialist

Position Summary

Join our dedicated accounting team as a Medical Billing Specialist! In this essential role, you’ll report to the Accounting Manager and be responsible for managing billing processes, submitting claims to insurance providers, and following up on outstanding invoices to ensure timely payments. Your ability to collaborate with healthcare providers, patients, and insurance companies will be key in ensuring all billing activities are handled accurately and efficiently.

Essential Duties And Responsibilities

To be successful in this role, you’ll perform the following essential functions, along with any additional tasks as assigned. We encourage individuals with disabilities to apply, and reasonable accommodations can be made to support you in performing these functions.

• Claims Preparation and Submission:
• Prepare, review, and submit medical claims to insurance companies, Medicare, Medicaid, and other third-party payers.
• Ensure accuracy and compliance with industry standards and regulations for all claims.
• Billing and Invoicing:
• Generate and send invoices to clients for services rendered.
• Maintain comprehensive records of all billing transactions.
• Payment Posting:
• Post payments received from insurance companies and clients.
• Reconcile payments and address any discrepancies.
• Follow-Up on Unpaid Claims:
• Monitor unpaid claims and proactively follow up with insurance companies or clients as needed.
• Resolve issues preventing timely payments, such as claim denials or rejections.
• Compliance and Confidentiality:
• Ensure all billing activities comply with relevant laws, regulations, and policies, including HIPAA.
• Uphold patient confidentiality and protect sensitive information.
• Reporting:
• Generate reports on billing activities, including aging reports, revenue cycles, and collection rates.
• Provide insights and recommendations to enhance billing efficiency and minimize claim denials.
  

Competencies

To thrive in this position, you should demonstrate the following qualities:

• Achievement Focus:
• Exhibit persistence and overcome obstacles. Set and achieve challenging goals while taking calculated risks.
• Business Ethics:
• Inspire trust, uphold organizational values, and work with integrity and ethical standards.
• Customer Focus:
• Develop innovative approaches to meet customer needs and ensure high customer satisfaction.
  

Qualifications

To perform this job successfully, you should meet the following qualifications:

• Education:
• High school diploma or equivalent; an associate's degree or certification in medical billing/coding is preferred.
• Experience:
• Previous experience in medical billing or a related field is preferred.
• Technical Skills:
• Proficient in medical billing software and electronic health record (EHR) systems.
• Strong computer skills, including Microsoft Office Suite (Word, Excel, Outlook).
• Communication Skills:
• Excellent verbal and written communication skills.
• Ability to effectively communicate with patients, healthcare providers, and insurance companies.
• Analytical Skills:
• Strong attention to detail and accuracy.
• Ability to analyze billing data and identify trends or issues.
• Problem-Solving Skills:
• Capable of resolving billing issues and disputes with strong organizational and time-management abilities.
  

Work Environment

The work environment is typically low in noise. Reasonable accommodations may be made to assist individuals with disabilities in performing essential functions.

Physical Demands

While performing the duties of this job, you may need to:

• Sit for extended periods.
• Use your hands to manipulate tools and communicate verbally.
• Occasionally stand and walk.
• Lift and move up to 10 pounds.
• Perform tasks requiring close vision.
  
  

This job description is not exhaustive and may be adjusted as needed. You may be asked to follow additional instructions and perform other related duties assigned by your supervisor.

Employment Type: Full-Time