Medical Billing Specialist

Medical Billing & Collections Specialist

We are seeking a highly motivated, detail-oriented, and experienced Medical Billing & Collections Specialist to join our growing team in Freehold, New Jersey. We are looking for a knowledgeable professional with a strong background in medical insurance billing, accounts receivable management, insurance collections, and reimbursement recovery. The ideal candidate will have extensive hands-on experience working with commercial insurance carriers, resolving complex claim denials, managing outstanding receivables, and maximizing reimbursement for healthcare providers. Experience with both in-network and out-of-network insurance claims is highly desirable. This position requires an individual who is organized, dependable, analytical, and capable of independently investigating and resolving complicated insurance billing issues.

Key Responsibilities

• Manage medical insurance claims throughout the complete revenue cycle, from submission through final reimbursement.
• Perform consistent and thorough insurance accounts receivable follow-up.
• Investigate and resolve denied, rejected, delayed, and underpaid claims.
• Prepare and submit corrected claims, reconsiderations, and formal insurance appeals.
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) for payment accuracy.
• Identify reimbursement discrepancies and pursue appropriate payment recovery.
• Communicate effectively with insurance carriers, claims representatives, and healthcare providers.
• Research insurance policies, billing guidelines, reimbursement methodologies, and payer requirements.
• Handle in-network and out-of-network claims, including complex reimbursement issues.
• Maintain accurate and detailed documentation of claim activity, appeals, and collection efforts.
• Monitor aging reports, prioritize outstanding balances, and support timely reimbursement.
• Maintain compliance with HIPAA and applicable healthcare billing regulations.

Required Qualifications

• 3-5 years of medical billing and insurance collections experience preferred.
• Strong knowledge of commercial insurance billing and revenue cycle management.
• Demonstrated experience in insurance A/R follow-up, denial resolution, and collections.
• Ability to interpret EOBs, ERAs, CPT codes, ICD-10 codes, and reimbursement information.
• Experience with medical billing software, insurance payer portals, and Microsoft Excel.
• Excellent verbal and written communication skills.
• Strong analytical, organizational, and problem-solving abilities.
• Ability to work independently, manage priorities, and maintain accuracy in a fast-paced environment.
• Experience with out-of-network insurance claims and reimbursement recovery.
• Knowledge of self-funded insurance plans and ERISA-related claim processes.
• Experience preparing detailed insurance appeals and reconsiderations.
• Physical therapy and chiropractic billing experience.
• Experience working for a third-party medical billing or revenue cycle management company.
• Familiarity with insurance payment negotiations and underpayment resolution.

Pay: $23.00 - $25.00 per hour