Medical Billing Specialist

Job Description

Job Description

Essential Job Responsibilities

• Research and resolve claim denials and rejections received from internal billing staff, insurance payers through Electronic Remittance Advice (ERA), and clearinghouses.

• Accurately post insurance payments, denials, and adjustments to patient accounts.

• Follow up on denied, rejected, unpaid, and incorrectly paid claims to ensure proper resolution.

• Submit claims through the MITS system when required.

• Split Medicare claims accurately according to applicable billing guidelines.

• Complete and fax required documentation for workers' compensation claims.

• Print and submit paper HCFA/CMS-1500 claims to insurance companies that do not accept electronic submissions.

• Reconcile patient accounts and insurance claims to ensure billing accuracy.

• Review claims for completeness and accuracy before submission.

• Attach supporting documentation to claims and prepare documentation for appeals when necessary.

• Contact insurance companies to resolve incorrect payments, claim discrepancies, missing payments, and copayment issues.

• Assist with posting remittance advice and deposits as needed.

• Respond to billing inquiries from patients, customers, and patient account representatives.

• Document all communications and follow-up activities related to patient accounts and claims.

• Assist front desk staff with insurance eligibility verification when needed.

• Provide billing guidance and support to providers, clinical staff, coding staff, and other billing team members.

• Maintain patient confidentiality and comply with applicable privacy requirements.

• Perform other related duties as assigned.

• Basic knowledge of medical terminology.

• Previous experience in medical billing and/or medical coding.

• Understanding of insurance claims processing, payment posting, denials, and claim reconciliation.

• Familiarity with Medicare billing and workers' compensation claims is preferred.

• Ability to learn and use Electronic Medical Records (EMR), Practice Management (PM) systems, and other billing software.

• Proficiency in standard office procedures, equipment, and computer applications.

• Strong organizational, analytical, and problem-solving skills.

• Excellent written and verbal communication skills.

• Strong attention to detail and accuracy in claim processing.

• Ability to manage multiple tasks and meet deadlines.

• Excellent customer service and interpersonal skills.

• Demonstrates teamwork and collaborates effectively with colleagues.

• Accepts and provides guidance and support when appropriate.

• Maintains high standards of personal and departmental performance.

• Demonstrates professionalism in appearance, communication, and workplace conduct.

• Handles high-pressure situations and time-sensitive tasks professionally.

• Works independently with minimal supervision.

• Maintains confidentiality and protects sensitive patient information.

• High school diploma or GED.

• Previous medical billing and/or coding experience.

• Excellent organizational and time-management skills.

• Professional demeanor and appearance.

• Strong customer service and interpersonal skills.

Protouch Staffing is a trusted staffing partner specializing in connecting skilled professionals with top employers. While we originally focused on healthcare staffing, we’ve expanded into legal and other domains to meet evolving workforce needs across industries.

Company Description

Protouch Staffing is a trusted staffing partner specializing in connecting skilled professionals with top employers. While we originally focused on healthcare staffing, we’ve expanded into legal and other domains to meet evolving workforce needs across industries.