Billing Specialist

Billing Specialist

We are looking for a motivated and detail-oriented ONSITE ONLY Billing Specialist to join our growing team. This role is essential in ensuring the accuracy, efficiency, and timeliness of our medical billing operations. You will be responsible for managing the full lifecycle of claims—from charge entry to payment posting—while working closely with internal teams, patients, and insurance payers.

This is a highly visible role that requires strong communication skills, critical thinking, and the ability to manage multiple priorities in a fast-paced healthcare environment.

What You'll Do

Billing & Claims Management

• Prepare, review, and submit accurate claims to commercial insurance payers (electronic and paper)
• Ensure proper use of ICD-10, CPT codes, and modifiers during charge entry
• Monitor claim status and proactively follow up on unpaid or delayed claims
• Identify and resolve claim rejections and denials in a timely manner
• Maintain detailed documentation of all billing activity and account updates

Accounts Receivable & Collections

• Post payments, adjustments, and reconcile accounts receivable balances
• Investigate and resolve outstanding balances, focusing on claims over 60 days old
• Work with patients to set up payment plans and resolve billing inquiries
• Collaborate with payers and internal teams to resolve discrepancies

Compliance & Accuracy

• Ensure all billing practices comply with HIPAA and applicable federal, state, and local regulations
• Maintain accuracy in billing records and internal controls
• Support internal and external audits by providing necessary documentation
• Stay up to date with payer rules and billing guidelines

Collaboration & Communication

• Communicate effectively with providers, clinic staff, and leadership regarding billing issues
• Partner with internal departments to ensure all billable services are captured
• Participate in team meetings, training sessions, and cross-functional initiatives
• Provide clear updates and accountability on assigned tasks and accounts

Process Improvement

• Identify inefficiencies or recurring issues and recommend solutions
• Contribute to improving workflows, reducing turnaround times, and increasing accuracy
• Support implementation of new billing processes, tools, or systems

What We're Looking For

Required Qualifications

• Previous medical billing experience (required)
• Strong understanding of claims processing and denial management
• Excellent attention to detail and accuracy
• Ability to manage multiple tasks and meet deadlines
• Strong verbal and written communication skills
• Ability to work both independently and within a team

Preferred Qualifications

• Experience with commercial insurance payers
• Familiarity with billing software systems
• Knowledge of healthcare revenue cycle processes

Education & Experience

• High School Diploma or GED required
• 1+ year of medical billing experience preferred (or equivalent combination of training and experience)