Medical Billing Specialist

Job Description Job Description Medical Billing Specialist Pay:$24.50/hr. Schedule: Monday-Friday Hours: 9:00am-5:30pm About the Employer- A well-established nonprofit organization is seeking a detail-oriented Medical Billing Specialist to join its team. This role supports healthcare-related billing operations and requires strong organizational skills, accuracy, and the ability to work effectively in a collaborative environment. This is a contract-to-hire opportunity with long-term potential. Position Summary- The Medical Billing Specialist will be responsible for processing medical claims, maintaining accurate billing records, and ensuring timely reimbursement from insurance providers. The ideal candidate will have experience navigating payer requirements, resolving billing discrepancies, and supporting the revenue cycle process. Strong communication skills and a commitment to quality service are essential. Essential Job Duties- Eligibility & Authorization Management Verify insurance eligibility and coverage prior to services being provided. Obtain and track required authorizations to ensure services meet payer requirements. Review eligibility criteria and coverage guidelines to determine reimbursement qualifications. Coordinate with internal departments to secure necessary documentation and approvals. Claims Processing & Billing Prepare and submit claims accurately and timely according to payer requirements. Review supporting documentation to ensure claim completeness and compliance. Verify coding, authorizations, and billing details prior to submission. Maintain accurate records and billing documentation throughout the revenue cycle. Accounts Receivable & Denial Management Monitor claim status and reimbursement activity from submission through payment. Follow up on outstanding, denied, or underpaid claims using payer portals and direct communication. Investigate claim discrepancies, correct billing issues, and resubmit claims as needed. Prepare appeals and supporting documentation to maximize reimbursement. Reconciliation & Reporting Reconcile payments and ensure proper allocation of reimbursements. Maintain accurate billing records within organizational systems. Generate reports related to accounts receivable, collections, denials, and payment trends. Analyze data to identify opportunities for process improvement and revenue recovery. Compliance & Collaboration Stay current on payer regulations, billing requirements, and reimbursement guidelines. Ensure all records are maintained in accordance with HIPAA and organizational policies. Build positive working relationships with insurance carriers, healthcare providers, and internal stakeholders. Collaborate with multiple departments to resolve documentation, authorization, and claim-related issues. Requirements- Two or more years of medical, Medicaid, or third-party billing and collections experience. Working knowledge of claim submission, denial management, and appeals processes. Understanding of HIPAA and the handling of protected health information (PHI). Strong attention to detail, organization, and ability to meet deadlines. Effective written and verbal communication skills with payers, care teams, families, and internal staff. Proficiency in Microsoft Office applications, particularly Excel, and experience using payer web portals. Benefits Include- Generous Paid Time Off: 144 hours of PTO annually, plus 12 paid holidays (10 standard holidays and 2 floating holidays). 100% Covered Healthcare: Medical and dental benefits fully paid for employees and their dependents. Retirement Savings: SIMPLE IRA with up to a 3% employer match. Annual volunteer hours to support community involvement. Employee Assistance Program (EAP). Work Environment- Primarily office-based computer and phone work; occasional travel between House locations and community event sites may be required. Ability to sit for extended periods and use a computer for the majority of the workday. Commitment to the mission of keeping families close to their hospitalized children. #J-18808-Ljbffr Emerald Staffing