Insurance Medical Billing Specialist

Job Description:

• Manage the end-to-end medical billing process for healthcare services
• Responsible for accurate claim submission, timely reimbursements, and maintaining compliance with insurance and healthcare regulations
• Prepare, review, and submit accurate medical claims to insurance providers
• Ensure proper coding using CPT, ICD-10, and HCPCS before claim submission
• Monitor claim status and follow up on unpaid, delayed, or rejected claims
• Handle claim corrections, resubmissions, and appeals as needed
• Verify patient insurance coverage, benefits, eligibility, co-pays, and deductibles
• Communicate insurance details clearly to internal teams or patients when necessary
• Track outstanding claims and maintain timely reimbursement follow-ups
• Follow up on denied or underpaid claims and provide supporting documentation
• Maintain accurate records of payment postings, adjustments, and billing activity
• Identify denial trends and recommend corrective actions to improve billing accuracy
• Investigate and resolve billing discrepancies and coding-related issues
• Ensure all billing practices comply with HIPAA and healthcare regulations
• Maintain organized and accurate billing documentation
• Stay updated on insurance policies, coding standards, and billing procedures
• Generate billing reports and track performance metrics such as claim acceptance rate and AR aging
• Collaborate with internal teams to improve billing workflows and collection efficiency
• Communicate effectively with insurance representatives and stakeholders

Requirements:

• Proven experience in medical billing, insurance billing, or revenue cycle management
• Strong knowledge of CPT, ICD-10, and HCPCS coding systems
• Experience working with U.S. healthcare insurance providers, including Medicare, Medicaid, and private insurers
• Familiarity with EHR, EMR, and medical billing software
• Strong understanding of claims processing, denial management, and accounts receivable follow-ups
• High attention to detail and accuracy in handling financial data
• Strong communication and problem-solving skills
• Ability to work independently and manage multiple billing tasks efficiently
• Experience in a healthcare, clinic, or medical practice setting is preferred
• Certification such as CPC or equivalent is preferred
• Experience with Kareo, AdvancedMD, Athenahealth, or similar platforms is preferred
• Knowledge of U.S. healthcare compliance and reimbursement processes is preferred

Benefits:

• Flexible work arrangements
• Health Insurance

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