Medical Billing Specialist

Job Description

Job Description

We are looking for a Medical Billing Specialist to join our team in Shelton, Washington in a contract capacity with the potential for a permanent role. This onsite position supports a tribal healthcare setting and plays an important role in keeping billing operations accurate, timely, and compliant. The person in this role will help manage claims, authorizations, referrals, and revenue cycle activities while working closely with patients, providers, and payers. This opportunity is ideal for someone who is comfortable balancing billing detail, insurance coordination, and patient support in a fast-paced clinic environment.

Responsibilities:
• Oversee the full claims process for medical, dental, Medicare, Medicaid, and commercial coverage, from submission through payment resolution.
• Review remittance details, post payments accurately, and investigate denied, rejected, or underpaid claims to secure proper reimbursement.
• Track outstanding receivables, follow up on unpaid balances, and take timely action to reduce aging accounts.
• Confirm insurance information, patient demographics, and service authorization needs before billing or referral processing begins.
• Obtain and manage prior approvals for services while coordinating with clinics, insurers, and external care providers.
• Support compliant billing practices by maintaining accurate documentation and applying appropriate coding and privacy standards.
• Coordinate referral-related activities, including eligibility review, purchase order processing, claim support, and follow-up with outside providers when needed.
• Assist patients with billing questions, insurance-related concerns, and benefit enrollment support, including Healthplanfinder guidance.
• Contribute to reporting, audit preparation, reconciliations, and general front-office coverage as needed to support clinic operations.• Experience in medical billing, claims processing, or revenue cycle work within a healthcare environment.
• Working knowledge of medical coding principles, payment posting, collections, and claim follow-up procedures.
• Familiarity with Medicare, Medicaid, commercial insurance, and coordination of benefits requirements.
• Ability to manage denials, authorizations, referrals, and accounts receivable with strong attention to detail.
• Understanding of HIPAA standards and the importance of maintaining patient privacy and secure records.
• Strong communication skills for working with patients, providers, insurance carriers, and administrative staff.
• Comfortable working onsite Monday through Friday during standard business hours.
• Prior experience in tribal healthcare, referral coordination, or benefits enrollment support is helpful but not required.