Medical Billing Specialist

JOB DESCRIPTION

The Medical Billing Specialist is responsible for providing exceptional customer service while ensuring accurate and timely claims processing in a professional medical clinic environment. This role supports patients with billing inquiries, communicates payment options, and protects the confidentiality of all patient and company information. The position involves reviewing, correcting, submitting, and following up on insurance claims; researching and appealing denied or unpaid claims; and verifying insurance payments for accuracy and compliance with contractual fee schedules.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Provides professional, courteous, and exceptional customer service to all patients, clients, and internal stakeholders.
• Provides professional and exceptional customer service to all.
• Collaborates effectively with co-workers and management to maintain a positive work environment and promote teamwork.
• Protects the privacy and confidentiality of clients and company information at all times in accordance with applicable policies and regulations.
• Assists patients with billing inquiries as needed and clearly communicates available payment options.
• Demonstrates strong attention to detail and proficiency with Imagines’ electronic and paper claims processing systems, including ERS and EOB modules.
• Works closely with the Billing Team Supervisor to identify opportunities to improve workflow efficiency and accuracy.
• Follows up on claim denials and unpaid claims within established timely filing limits.
• Researches, prepares, and submits appeals for denied claims as appropriate.
• Corrects claim errors and resubmits claims in a timely manner when necessary.
• Reviews insurance payments to ensure accuracy and compliance with contractual fee schedules and discount agreements.
• Provides training and guidance to new billing staff on daily workflow processes and serves as a key resource for procedural and workflow-related questions.
• Attendance and Dependability: Consistently reports to work as scheduled, maintains reliable attendance, and is seldom absent.
• Performs other duties as assigned.
• Performs other related duties as identified.

MINIMUM EDUCATION AND EXPERIENCE

• High School Diploma
• Minimum of two years post-secondary education in a Medical or Business-related field.
• Minimum of two years’ experience in a medical office setting or equivalent experience.
• Previous experience as a Medical Biller strongly preferred.

KNOWLEDGE AND SKILLS

• Ability to communicate effectively, clearly, and professionally with all levels of the organization as well as external contacts.
• Demonstrated ability to handle difficult situations and individuals with professionalism, tact, and a positive attitude.
• Applies effective listening skills to ensure accurate understanding and resolution of concerns.
• Proficiency with computer systems and standard office software applications.
• Strong organizational and time-management skills with the ability to prioritize tasks effectively.
• Ability to maintain strict confidentiality and handle sensitive information appropriately.
• Working knowledge of insurance guidelines and requirements, including HMO/PPO plans, Medicare, Medicaid, and other third-party payers.
• Strong problem-solving and analytical skills to research and resolve discrepancies related to denials, appeals, claims, and collections.
• Competent use of Imagine billing software or the ability to achieve proficiency within six months of hire.

WORKING AND ENVIRONMENTAL CONDITIONS

Normal Medical Clinic Environment: Indoors in a clean, well illuminated area of constant temperature in which one is exposed to only noise from business machines and medical practice equipment. Protective measures are necessary based on the level of exposure to bloodborne pathogens and hazardous substances.

PHYSICAL REQUIREMENTS

• Periodic Lifting: 5-50 pounds periodically.
• Eye-hand coordination and manual dexterity sufficient for operation of standard office equipment.
• Repetitive movement of digits.
• Normal range of hearing and vision.
• Ability to speak in a clearly understood manner.
• Prolonged sitting, some bending, stooping, lifting, and stretching.

Job Type: Full-time

Pay: $17.00 - $23.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person