Medical Claims & Billing Specialist

Job Description

Job Description

This is a remote position.

We’re looking to hire a  Medical Claims & Billing Specialist who can support day-to-day medical billing, claims processing, and account administration. Candidates applying for the role should be highly organized, detail-oriented, and able to manage multiple claims, billing records, and follow-up activities while maintaining accuracy and confidentiality.

Experience with medical billing, healthcare claims, insurance processing, revenue cycle management, patient accounts, or healthcare administration is highly valued. Candidates should have strong computer skills and an understanding of billing procedures, insurance terminology, claim documentation, and the importance of accurate financial records.

Ideally, the candidate should be able to review and submit claims, identify billing discrepancies, communicate with insurance providers and patients when necessary, maintain accurate records, and follow outstanding claims through resolution. The candidate should contribute to efficient healthcare operations by helping ensure claims and billing activities are completed accurately and on time.

Responsibilities

• Review and process medical claims and billing information for accuracy and completeness.
  
• Prepare and submit electronic and paper claims to insurance providers as required.
  
• Verify patient, member, insurance, and billing information.
  
• Review claim status and follow up on pending, rejected, or denied claims.
  
• Research billing discrepancies and assist with correcting claim errors.
  
• Maintain accurate billing, payment, and claims records in applicable systems.
  
• Communicate with insurance providers regarding claim status, documentation, and billing requirements.
  
• Respond to routine patient or member billing inquiries in a professional manner.
  
• Assist with payment posting, account reconciliation, and outstanding balance follow-up.
  
• Prepare billing reports, claim summaries, correspondence, and other related documentation.
  
• Maintain confidentiality and follow applicable healthcare privacy and security requirements.
  
• Coordinate with internal healthcare and administrative teams to resolve billing and claims issues.
  
• Stay informed about applicable billing procedures, payer requirements, and organizational policies.
  
• Perform other billing, claims, and administrative duties as assigned.
  

Requirements

• Proven work experience as a Medical Billing Specialist, Claims Specialist, Billing Coordinator, Patient Accounts Specialist, or similar role.
  
• Knowledge of medical billing, healthcare claims, insurance processes, and revenue cycle activities.
  
• Experience with medical billing software, EHR systems, practice-management systems, or claims platforms.
  
• Strong computer skills, including Microsoft Office or comparable productivity software.
  
• Working knowledge of medical terminology and common insurance terminology.
  
• Strong attention to detail and accuracy when processing financial and healthcare information.
  
• Excellent organizational and time-management skills.
  
• Ability to manage multiple claims, accounts, priorities, and deadlines.
  
• Strong written and verbal communication skills.
  
• Strong analytical and problem-solving skills.
  
• Ability to research claim issues and follow problems through to resolution.
  
• Ability to maintain confidentiality and appropriately handle protected health information.
  
• Professional and courteous communication style when working with patients, members, providers, and insurance representatives.
  
• High school diploma or equivalent required; associate’s degree or relevant medical billing certification is preferred.
  

Benefits

Eligible employees may receive a comprehensive benefits package, including:

• Medical, Dental & Vision Insurance
  
• 401(k) Retirement Plan
  
• Paid Time Off (PTO)
  
• Paid Holidays
  
• Flexible Work Schedule
  
• Remote / Work-from-Home Opportunity
  
• Employee Assistance Program
  
• Professional Development & Training
  

Equal Opportunity

We are committed to providing a professional, respectful, and inclusive workplace. Employment decisions are based on qualifications, experience, skills, organizational needs, and other lawful considerations. Qualified candidates from diverse backgrounds are encouraged to apply.