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