Billing Associate

The Medical Billing Specialist is responsible for accurately processing medical claims, posting payments, managing accounts receivable, resolving billing issues, and following up with insurance companies and patients to ensure timely reimbursement. This position works closely with healthcare providers, insurance companies, and internal departments to support an efficient revenue cycle.

• Prepare, review, and submit medical claims to insurance companies and government payers.
• Verify patient demographics, insurance coverage, eligibility, and benefits.
• Review claims for accuracy and completeness prior to submission.
• Enter charges, payments, adjustments, and other billing information into the practice management system.
• Post insurance and patient payments accurately and timely.
• Monitor unpaid and outstanding claims and conduct appropriate follow-up.
• Research and resolve denied, rejected, and underpaid claims.
• Prepare and submit insurance appeals and corrected claims when necessary.
• Review accounts receivable aging and follow up on outstanding balances.
• Communicate with insurance companies regarding claim status, eligibility, authorizations, and reimbursement.
• Respond to patient billing inquiries and explain balances, payments, and insurance processing.
• Maintain accurate billing records and documentation.
• Reconcile billing transactions and identify discrepancies.
• Work with clinical and administrative staff to resolve missing documentation, coding, registration, and authorization issues.
• Maintain compliance with HIPAA and applicable healthcare billing regulations.
• Stay current on payer requirements, billing guidelines, and reimbursement policies.
• Assist with month-end billing reports and revenue cycle activities.

• High school diploma or equivalent required; associate degree preferred.
• 2+ years of medical billing or healthcare revenue cycle experience.
• Knowledge of medical terminology, insurance terminology, and billing procedures.
• Familiarity with CPT, ICD-10, and HCPCS codes.
• Experience billing Medicare, Medicaid, and commercial insurance plans.
• Strong understanding of claims processing, payment posting, denials, and accounts receivable.
• Experience with electronic medical records (EMR) and practice management/billing systems.
• Proficiency with Microsoft Office, particularly Excel.
• Ability to prioritize work and meet billing deadlines.

• Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS).
• Experience with high-volume medical billing.
• Experience with denial management and insurance appeals.
• Knowledge of HIPAA and healthcare revenue cycle compliance.
• Previous experience in a physician practice, hospital, medical group, specialty clinic, or healthcare organization.