Medical Billing Specialist

Medical Billing Specialist is responsible for accurately processing medical claims, ensuring timely reimbursements, and maintaining compliance with insurance policies and regulations. This role requires strong analytical skills, attention to detail, and determining verification of insurance and request of referrals.

Key Responsibilities:

• Prepare and submit medical claims to insurance companies and government payers.

• Verify patient insurance coverage and eligibility.

• Determine rejections, process the corrections and re-bill.

• Maintain accurate documentation.

• Generate reports related to billing, collections, and accounts receivable.

• Communicate with patients and insurances.

Required Qualifications and Skills:

• High school diploma or equivalent, Associate’s Degree preferred.

• Certification in medical billing and coding (CPC, CCS, or equivalent)

• Minimum 3 years of experience as a Medical Billing Specialist or in a similar role.

• Proficiency in medical billing software and electronic health records (EHR) systems.

• Strong knowledge of CPT, ICD-10, and HCPCS coding; differentiating between Medicare and private insurances, Medicare part A and B, HMO/PPO insurance, primary and secondary/supplemental insurance.

• Good computer skills, including Excel.

• Familiarity with insurance policies, claim procedures, and reimbursement guidelines.

• Excellent attention to detail and problem-solving skills.

• Strong organizational and communication abilities.

• Experience working with billing software.