Medical Billing Specialist

Job Description

Job Description

We are looking for a Medical Billing Specialist to support revenue cycle operations for a healthcare setting in Philadelphia, Pennsylvania. This Contract position focuses on accurate claim handling, payer follow-up, and timely reimbursement across multiple insurance types, including Keystone, auto, workers’ compensation, and commercial plans. The ideal candidate brings strong billing knowledge, sharp attention to detail, and the ability to manage claim activity efficiently in a fast-paced environment.

Responsibilities:
• Process and submit medical claims for multiple payer categories, ensuring each submission is complete, accurate, and aligned with insurance guidelines.
• Investigate unpaid, delayed, or denied claims and work with payer representatives to drive resolution and secure payment.
• Review billing records for errors or inconsistencies, make necessary corrections, and promptly refile claims when needed.
• Monitor payer-specific rules, reimbursement terms, coding standards, and applicable billing regulations to maintain compliance.
• Coordinate with internal teams such as coding, registration, and clinical staff to gather information needed for clean claim processing.
• Respond to insurance requests and provide supporting documentation to address claim questions or outstanding issues.
• Record account activity, update claim status notes, post remittance details, and reconcile payer and patient balances.
• Contribute to denial review efforts and support audit-related activities by maintaining thorough and accurate billing documentation.• At least 2 years of experience in hospital or physician billing within a multi-payer environment.
• Hands-on familiarity with medical billing workflows, insurance claims processing, and account follow-up procedures.
• Working knowledge of medical coding standards, including ICD-10 and CPT, as they relate to billing accuracy.
• Experience using electronic medical records, billing platforms, and payer portal systems such as ePaces.
• Strong organizational skills with the ability to manage high claim volume and meet deadlines consistently.
• High level of accuracy and attention to detail when reviewing claims, payments, and account discrepancies.
• Effective communication skills for interacting with insurance carriers and cross-functional healthcare teams.