Medical Billing Specialist

Job Description

Job Description

Full Job Description

Job Type: Full-Time | In-Office

Job Description

We seeking a highly motivated, detail-oriented, and experienced Medical Billing & Collections Specialist to join our growing team in Freehold, New Jersey.

We are looking for a knowledgeable professional with a strong background in medical insurance billing, accounts receivable management, insurance collections, and reimbursement recovery.

The ideal candidate will have extensive hands-on experience working with commercial insurance carriers, resolving complex claim denials, managing outstanding receivables, and maximizing reimbursement for healthcare providers.

Experience with both in-network and out-of-network insurance claims is highly desirable.

This position requires an individual who is organized, dependable, analytical, and capable of independently investigating and resolving complicated insurance billing issues.

Key Responsibilities

• Manage medical insurance claims throughout the complete revenue cycle, from submission through final reimbursement.

• Perform consistent and thorough insurance accounts receivable follow-up.

• Investigate and resolve denied, rejected, delayed, and underpaid claims.

• Prepare and submit corrected claims, reconsiderations, and formal insurance appeals.

• Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) for payment accuracy.

• Identify reimbursement discrepancies and pursue appropriate payment recovery.

• Communicate effectively with insurance carriers, claims representatives, and healthcare providers.

• Research insurance policies, billing guidelines, reimbursement methodologies, and payer requirements.

• Handle in-network and out-of-network claims, including complex reimbursement issues.

• Maintain accurate and detailed documentation of claim activity, appeals, and collection efforts.

• Monitor aging reports, prioritize outstanding balances, and support timely reimbursement.

• Maintain compliance with HIPAA and applicable healthcare billing regulations.

Required Qualifications

• 3-5 years of medical billing and insurance collections experience preferred.

• Strong knowledge of commercial insurance billing and revenue cycle management.

• Demonstrated experience in insurance A/R follow-up, denial resolution, and collections.

• Ability to interpret EOBs, ERAs, CPT codes, ICD-10 codes, and reimbursement information.

• Experience with medical billing software, insurance payer portals, and Microsoft Excel.

• Excellent verbal and written communication skills.

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

• Ability to work independently, manage priorities, and maintain accuracy in a fast-paced environment.

• Experience with out-of-network insurance claims and reimbursement recovery.

• Knowledge of self-funded insurance plans and ERISA-related claim processes.

• Experience preparing detailed insurance appeals and reconsiderations.

• Physical therapy and chiropractic billing experience.

• Experience working for a third-party medical billing or revenue cycle management company.

• Familiarity with insurance payment negotiations and underpayment resolution.

What We're Looking For:

We are seeking a professional who goes beyond routine claim submission and understands the importance of effective insurance follow-up, reimbursement accuracy, and successful collection outcomes.

The successful candidate will demonstrate initiative, accountability, attention to detail, and a commitment to delivering exceptional billing and collections services.

Focused Billing & Collection LLC is looking for dedicated professionals who take pride in their work and are committed to achieving excellent results.

Pay: $23.00 - $25.00 per hour

Application Question(s):

• What medical specialties have you billed for, and which billing software systems have you used?

• How many years of direct, hands-on out-of-network medical insurance billing and collections experience do you have?

Experience:

• Medical billing: 3 years (Required)

Work Location: In person

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.