Medical Billing Specialist

Medical Billing Help is a leading provider of comprehensive medical billing, coding, and revenue cycle management services, supporting over 1,500 healthcare providers across more than 75 medical specialties. With a team of more than 1,200 billing and coding professionals, the company is dedicated to enhancing cash flow, minimizing claim denials, and optimizing operational efficiency. Their services include A/R follow-up, denial management, provider credentialing, and strict adherence to HIPAA and industry regulations. Focused on accuracy and transparent reporting, Medical Billing Help aims to simplify billing processes so healthcare providers can concentrate on delivering excellent patient care.

The Medical Billing Specialist position is a full-time, on-site role based in Karāchi. The specialist will be responsible for preparing, submitting, and tracking medical claims with insurance companies, Medicare, and other payers to ensure timely and accurate reimbursement. Daily activities include reviewing clinical documentation, assigning ICD-10 codes, verifying patient insurance coverage, and resolving claim denials or discrepancies. The role also involves conducting A/R follow-up, communicating with payers and provider offices, maintaining compliance with relevant regulations, updating billing records, generating reports, and collaborating with internal teams to enhance billing workflows and overall revenue cycle performance.

Key Responsibilities
- Prepare and submit medical claims accurately to various payers, including insurance companies and government programs.
- Review clinical documentation and assign appropriate ICD-10 codes in compliance with coding standards.
- Verify patient insurance eligibility and coverage details before claim submission.
- Manage and resolve claim denials by analyzing root causes and pursuing appeals or corrections.
- Perform accounts receivable (A/R) follow-up to ensure timely payment and reconciliation of claims.
- Communicate effectively with payers, provider offices, and internal teams to resolve billing issues.
- Maintain compliance with HIPAA regulations and company policies related to billing and coding.
- Update and maintain accurate billing records and generate reports to track revenue cycle metrics.
- Collaborate with multidisciplinary teams to identify and implement process improvements.

Required Qualifications
- Strong knowledge of medical terminology and clinical documentation relevant to billing and coding.
- Practical experience working with insurance payers, including commercial plans and government programs such as Medicare.
- Proficiency in ICD-10 coding and a thorough understanding of billing standards and compliance requirements.
- Demonstrated ability to manage claim denials, including root cause analysis and resolution through appeals or corrections.
- Familiarity with revenue cycle management processes, including A/R follow-up and claim reconciliation.
- Ability to work on-site in Karāchi, manage multiple priorities, and meet deadlines in a fast-paced environment.
- Excellent numerical, analytical, and problem-solving skills with strong attention to detail and data accuracy.
- Effective written and verbal communication skills, with the ability to collaborate across teams.
- Experience using medical billing software, electronic health record (EHR) systems, and proficiency in MS Office applications.
- Relevant certification or formal training in medical billing, coding, or healthcare administration is required. Prior billing experience is preferred.

This role offers the opportunity to work within a reputable organization committed to delivering measurable results and supporting healthcare providers in streamlining their revenue cycle processes.