Medical Billing Specialist (Experienced)

The Medical Billing Specialist is responsible for managing patient accounts receivable through payer collection efforts.

Essential Job Functions

  • Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI) or other sensitive and personal information.
  • Compiles, sorts, and verifies accuracy of claim data to be entered into billing system.
  • Runs insurance A/R reports and calls carriers regarding status of outstanding claims, enters appropriate claim follow up notes on patient accounts in PM system.
  • Follows up and resolves payer rejections, denials and reduced payments.
  • Secures needed medical documentation required or requested by third party insurances.
  • Prepares and submits hard copy claims to third-party insurance carriers when necessary.
  • Verifies patient insurance for scheduled visits ahead of time, if needed.
  • Assists Patient Accounts Specialist with patient phone calls when requested.
  • Reads and analyzes clearinghouse reports as directed.
  • Follows up on insurance denials and takes appropriate steps to resolve discrepancies.
  • Communicates discrepancies and the need for additional information to the appropriate parties.
  • Keeps supervisor apprised of matters regarding billing system or payer issues causing claim denials or rejections.


High School graduate (or GED) required.

5+ years of medical billing experience in a health care organization required.

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