Medical Billing Specialist

We are looking for a detail-oriented and experienced Medical Billing Specialist to join our expanding Revenue Cycle Management (RCM) team. In this role, you will oversee the entire medical billing process, ensuring claims are submitted accurately and reimbursements are received promptly. You will also ensure compliance with US healthcare payer guidelines. Collaboration with healthcare providers, insurance companies, and internal teams will be essential to resolve billing issues, reduce claim denials, and support smooth revenue cycle operations.

Key Responsibilities

- Prepare, review, and submit precise medical insurance claims to both commercial and government payers.
- Verify patient insurance eligibility, benefits, and coverage before submitting claims.
- Accurately enter charges, payments, and adjustments into the billing system.
- Review claims for accuracy, completeness, and compliance with payer requirements.
- Investigate and resolve denied or rejected claims through timely follow-up, appeals, and corrections.
- Coordinate with insurance companies, clinics, and internal stakeholders to address billing discrepancies.
- Identify and correct coding or billing errors to improve claim acceptance rates.
- Maintain thorough documentation of billing activities and communications within the practice management system.
- Stay current with Medicare guidelines, payer policies, and industry regulations.
- Contribute to process improvements that enhance billing efficiency and overall revenue cycle performance.

Required Qualifications

- Minimum of 2 years of hands-on experience in Medical Billing or Revenue Cycle Management, preferably supporting US healthcare providers.
- Strong understanding of US medical terminology and healthcare documentation.
- Proven experience managing claim denials, including root cause analysis, appeals, resubmissions, and accounts receivable (AR) management.
- Working knowledge of ICD-10 coding and its application in medical billing.
- Familiarity with commercial insurance payers, eligibility verification, pre-authorizations, and claim processing.
- Good understanding of Medicare regulations, policies, and billing requirements.
- Experience using Practice Management Systems (PMS), Electronic Health Records (EHR), and Microsoft Office applications, especially Excel.
- Excellent analytical skills with strong attention to detail and numerical accuracy.
- Ability to handle high claim volumes while maintaining productivity and quality standards.
- Strong written and verbal communication skills.

Preferred Qualifications and Benefits

- Certification in Medical Billing, Medical Coding, Healthcare Administration, or a related field is an advantage.
- Experience working with US healthcare providers or medical billing companies is highly preferred.

This role offers the opportunity to be part of a dynamic team focused on optimizing revenue cycle processes and ensuring compliance with evolving healthcare regulations. If you are a motivated professional with a keen eye for detail and a commitment to accuracy, this position provides a rewarding environment to advance your career in medical billing.