Medical Billing Specialist

Medical Billing Specialist

Martindale Brightwood Health Center - 2855 N Keystone Avenue, Suite 100, Indianapolis, IN 46218

Fair Labor Standards Act Classification: Non-Exempt

Position will be working onsite and remotely.

The Medical Billing Specialist position is responsible for the accurate and timely submission, research, follow-up, correction, and resolution of medical claims for Medicare, Medicaid, Commercial, HMO, and PPO payers. This role requires strong knowledge of medical billing processes, insurance guidelines, payer requirements, denial management, and account resolution strategies to reduce accounts receivable aging and enhance reimbursement outcomes.

Additional responsibilities may include assisting with patient payment arrangements, payment posting support, account resolution activities, and coordination with collection agencies when necessary; however, the primary focus of this role is medical billing, claims management, and insurance resolution.

Responsibilities include:

• Submit, review, correct, and follow up on electronic and paper medical claims for Medicare, Medicaid, Commercial, HMO, and PPO payers.
• Research and resolve claim denials, rejections, edits, underpayments, and outstanding insurance balances.
• Review billing for accuracy, completeness, and compliance with payer guidelines and billing regulations.
• Analyze accounts to reduce aging and improve reimbursement outcomes and cash flow.
• Identify and resolve billing issues arising from coding, registration, insurance eligibility, authorization, or claim processing errors.
• Serve as liaison between payers, patients, providers, referral sources, and internal departments regarding billing and claim resolution.
• Review third-party payment listings and take appropriate action to prevent account aging.
• Make recommendations regarding account resolution and escalation needs when appropriate.
• Assist with payment posting activities, patient payment arrangements, and collection processes as needed.
• Maintain confidentiality of all patient medical, financial, and personal information in accordance with HIPAA and organizational policies.

Preferred qualifications include strong experience working with Medicare, Medicaid, and Commercial insurance billing and follow-up, along with demonstrated knowledge of claim resolution and denial management processes.

HealthNet is a nonprofit 501 (c) (3) organization of community-based health centers located in Indianapolis and Bloomington, IN Since 1968, HealthNet has improved the health status of the neighborhoods it serves by making quality health services accessible to everyone. HealthNet annually provides affordable health care to more than 61,000 individuals through its network of 9 primary care health centers 5 dental clinics, 9 school-based clinics, a mobile health unit, and additional support services. HealthNet's mission is to improve lives with compassionate health care and support services, regardless of ability to pay.

Qualifications, Knowledge, Skills, Abilities

• Requires prior experience in medical billing, claim follow-up, denial resolution, and third-party payer reimbursement processes with strong knowledge of Medicare, Medicaid, and Commercial payer requirements.
• Requires knowledge and proper application of payer policy, reimbursement methodologies, contractual adjustments, allowable amounts, denials, discounts, and payment resolution processes.
• Requires basic knowledge of medical terminology, as well as working knowledge of coding concepts including CPT, HCPCS, ICD-10, and UB claim requirements and medical billing practices.
• Requires knowledge and use of electronic payer inquiry systems, claim status portals, and insurance research tools for Medicare, Medicaid, Blue Cross, and other Commercial payers.
• Requires ability to research and resolve credit balances, debit balances, adjustment claims, and reimbursement discrepancies with Medicare and Medicaid payers.
• Requires strong analytical and critical thinking skills with the ability to identify claim issues, payment variances, denial trends, and account discrepancies.
• Requires ability to work independently and demonstrate strong self-directed research and problem-solving skills.
• Requires ability to manage multiple accounts, priorities, and workflow assignments simultaneously while meeting productivity and quality standards.
• Requires ability to adapt to changing workflows, payer requirements, departmental priorities, and shifting responsibilities while maintaining productivity, accuracy, and professionalism in a fast-paced healthcare environment.
• Requires knowledge of medical billing systems, electronic claim processing, payment posting, and account resolution workflows.
• Requires ability to handle sensitive patient information while maintaining a high degree of confidentiality in accordance with HIPAA standards.
• Requires strong organizational, customer service, listening, written, and verbal communication skills.
• Requires ability to work efficiently, accurately, and professionally under pressure while exercising appropriate judgment and attention to detail.
• Requires the ability to understand operational workflows, departmental objectives, and compliance requirements while following established procedures.
• Requires ability to successfully complete annual competency and departmental training requirements.
• Requires High School Diploma or equivalent.
• Travel may be required.

Why work for HealthNet?

• Competitive Compensation
• Medical, Dental, and Vision Plan
• Short-Term & Long-Term Disability
• Health Savings Account & Difference Card Available within certain medical plans
• Flexible Spending Account
• Life Insurance, AD&D
• Group Accident, Critical Illness & Hospital Indemnity
• Domestic Partner Leave
• Wellness Programs
• 401k Match
• Paid Time Off accumulates at start of employment and available to use.
• Tuition Reimbursement
• Employee Referral program

Equal Employment Opportunity:

HealthNet is an Equal Employment Opportunity Employer and employment decisions are made without regard to race, color, sex, religion, national origin, age, disability, sexual orientation, or any other category protected by federal, state, or local law.