A Medical Billing Specialist ensures accurate and timely billing for healthcare services. This role involves processing insurance claims, coding procedures, resolving billing discrepancies, and maintaining compliance with healthcare regulations. The specialist acts as a liaison between healthcare providers, insurance companies, and patients.
Key Responsibilities:
- Review patient records and verify billing information for accuracy.
- Code medical procedures and diagnoses using ICD-10, CPT, and HCPCS standards.
- Submit claims to insurance companies and government payers.
- Follow up on unpaid claims and appeal denied ones.
- Resolve billing discrepancies and respond to patient inquiries.
- Maintain billing software and electronic health records (EHR).
- Monitor accounts receivable and generate billing reports.
- Ensure compliance with HIPAA and other healthcare regulations.
- Collaborate with healthcare providers to clarify documentation.
Required Skills & Qualifications:
- Proficiency in medical billing software and EHR systems, Epic preferred.
- Strong understanding of medical terminology and coding principles.
- Excellent attention to detail and organizational skills.
- Effective communication and customer service abilities.
- Ability to manage multiple tasks and meet deadlines.
- Familiarity with insurance claim processes and healthcare regulations.
Education & Experience:
- Minimum: High school diploma or equivalent.
- Preferred: Associate degree in medical billing, coding, or healthcare administration.
- Certifications (highly valued):
- Certified Professional Coder (CPC) – AAPC
- Certified Billing and Coding Specialist (CBCS) – NHA
- Experience: 1–2 years in medical billing or related healthcare roles.
Job Type: Full-time
Pay: $23.00 - $29.00 per hour
Benefits:
- 401(k) matching
- Health insurance
- Paid time off
Work Location: In person
