The Medical Billing Specialist is responsible for managing the end‑to‑end medical billing process for healthcare services, ensuring accurate insurance claims submission, payment posting, and timely follow‑up on unpaid or denied claims.

This role involves working closely with internal teams and external payers to support revenue cycle operations and maintain compliance with healthcare regulations.

Responsibilities

• Prepare, review, and submit insurance claims accurately to payers based on patient treatment and coded documentation.

• Verify patient insurance eligibility and coverage before claim submission to reduce denials.

• Monitor and follow up on unpaid, denied, or rejected claims, make corrections and resubmit as needed.

• Post payments, adjustments, and reconcile billing statements in the billing system.

• Communicate with insurance companies to resolve discrepancies, denials, or payment issues.

• Respond to billing inquiries from patients, providers, and other stakeholders.

• Maintain accurate billing records and ensure compliance with HIPAA and other applicable regulations.

• Collaborate with team members and internal departments to ensure smooth revenue cycle workflows.

Requirements

• High school diploma or equivalent; associate’s or bachelor’s degree in healthcare administration, business, or related field preferred.

• Prior experience in medical billing, claims processing, or related healthcare billing functions is desirable.

• Proficiency with medical billing software and Electronic Health Record (EHR) or practice management systems.

• Strong attention to detail and accuracy in processing claims and payment posting.

• Excellent communication skills for interacting with payers, patients, and internal teams.