senior medical billing specialist

CacheLogic

Job SummaryWe are seeking a detail-oriented and experienced Medical Billing Specialist to manage the end-to-end medical billing process. The ideal candidate should have hands-on experience with US healthcare billing, insurance claims, payment posting, denial management, and revenue cycle management (RCM). The candidate must ensure timely claim submissions, accurate billing, and maximum reimbursement while maintaining compliance with HIPAA and payer guidelines.Key Responsibilities<ul><li>Prepare, review, and submit medical claims to insurance companies.</li><li>Verify patient insurance eligibility and benefits.</li><li>Process electronic and paper claims accurately.</li><li>Follow up on unpaid, denied, or rejected claims.</li><li>Analyze denials and resolve billing issues promptly.</li><li>Post insurance and patient payments accurately.</li><li>Generate patient statements and coordinate collections.</li><li>Review medical documentation for billing accuracy.</li><li>Ensure compliance with HIPAA and insurance regulations.</li><li>Maintain accurate billing records and documentation.</li><li>Coordinate with providers, insurance companies, and patients regarding billing inquiries.</li><li>Meet daily and monthly billing productivity targets.</li><li>Support revenue cycle management (RCM) activities.</li></ul>Required Qualifications<ul><li>Bachelor's degree (preferred).</li><li>2+ years of experience in US Medical Billing.</li><li>Strong understanding of Revenue Cycle Management (RCM).</li><li>Knowledge of ICD-10, CPT, and HCPCS coding.</li><li>Experience with insurance verification and authorization.</li><li>Hands-on experience with claim submission and denial management.</li><li>Familiarity with Medicare, Medicaid, and Commercial Insurance.</li><li>Experience using EMR/EHR and Medical Billing Software.</li><li>Excellent communication and analytical skills.</li><li>Strong attention to detail and problem-solving abilities.</li></ul>Preferred Skills<ul><li>AR Follow-up</li><li>Payment Posting</li><li>Charge Entry</li><li>Eligibility Verification</li><li>Claims Processing</li><li>Denial Management</li><li>Medical Coding Knowledge</li><li>HIPAA Compliance</li><li>Revenue Cycle Optimization</li><li>Excel and Reporting</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>Current Salary?</li><li>Expected salary?</li><li>This is onsite role are you comfortable? </li><li>Office time is night shift are you ok with it?</li></ul>Work Location: In person

Medical Billing Executive / Medical Billing Specialist

ASSOCIATED RETINA CONSULTANTS

<div>About Us
Since 1974, Associated Retina Consultants has an experienced team of Arizona eye specialists to diagnose and treat your vision problem. Our focus is on the retina, macula, and the vitreous humor in the eye. We work hard every day to protect and save our patients vision, helping them lead better quality lives.
Position Summary:
We are looking for an organized, efficient Medical Billing Specialist with an eye for detail and high level of accuracy. The Billing Specialist is responsible for posting insurance payments, entering charges, and assisting patients with their accounts. Position requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, co-pays, deductibles, allowable, CPT codes and Dx codes.
Responsibilities:<ul><li>
Work with personal information and maintain patient confidentiality</li><li>
Weekly and monthly reporting to executive director and billing supervisor.</li><li>
Verify the accuracy of all claims before submission and ensure all claims are submitted with a goal of zero errors and review claims and claims denials to ensure maximum reimbursement for services provided.</li><li>
Utilize monthly aging accounts receivable reports for follow-up on unpaid claims aged over 30 days.</li><li>
Review referrals and authorizations</li><li>
Respond to questions and complaints from patients or insurance companies</li><li>
Research and appeal denied claims.</li><li>
Read and interpret insurance explanation of benefits and respond to inquiries from insurance companies, patients, and providers.</li><li>
Other responsibilities as judgment or necessity dictate.</li><li>
Meet defined department goals and activity metrics.</li><li>
Initiate late payment notices to relevant parties</li><li>
Identify and bill secondary and/or third-party insurances.</li><li>
Follow set billing processes and procedures and follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO.</li><li>
Ensure patient information is accurate and complete and request any missing patient information.</li><li>
Create both paper and electronic copies of documentation</li><li>
Collect delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur.</li></ul>
Education and Experience:<ul><li>
High School Diploma or Equivalent required.</li><li>
2+ years medical billing experience preferred.</li><li>
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.</li><li>
Proficient in Microsoft Word, Outlook, Excel, and 10 key calculators.</li><li>
Basic knowledge of medical terminology, including CPT/ICD-10 coding.</li><li>
Effective communication abilities for phone contacts with insurance payers to resolve issues.</li><li>
Knowledge of medical terminology likely to be encountered in medical claims</li><li>
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).</li></ul>
Skills:<ul><li>
Planning and organizing</li><li>
Attention to detail, accuracy, and efficiency</li><li>
Problem-solving</li><li>
Teamwork</li><li>
Multitasking</li><li>
Customer service</li><li>
Electronic Medical Records (EMR)</li><li>
Communication skills - verbal and written</li><li>
Integrity</li></ul>
Benefits: Medical, Dental, Vision, Life Insurance, Disability Insurance, Paid Holidays, Vacation and Sick Time and much more.
Physical Requirements:<ul><li>
Prolonged periods sitting at a desk and working on a computer.</li><li>
Must be able to lift up to 15 pounds at times.</li></ul>
In office environment with controlled atmosphere. Possible exposure to staff or patients with communicable diseases and blood borne pathogens.
The Company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employees ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the Company reserves the right to change this job description and/or assign tasks for the employee to perform, as the Company may deem appropriate.
Associated Retina Consultants is an Equal Opportunity Employer.</div>

Medical Billing Specialist

Astro Medical Billing

OverviewJoin our dynamic healthcare team as a Medical Billing Specialist and become a vital part of ensuring accurate and efficient billing processes. In this role, you will manage the full cycle of medical billing, from coding and claims submission to follow-up on outstanding balances. Your expertise will help streamline revenue cycles, improve cash flow, and enhance patient satisfaction. If you are passionate about healthcare administration and thrive in a fast-paced environment, this opportunity is perfect for you to make a meaningful impact every day.Duties<ul><li>Review and verify medical records, ensuring accuracy of documentation for billing purposes</li><li>Assign appropriate codes using CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) systems to facilitate precise claims submission</li><li>Prepare and submit healthcare claims electronically using specialized billing software and EMR/EHR (Electronic Medical Records/Electronic Health Records) systems</li><li>Follow up on unpaid or denied claims by communicating with insurance providers and patients to resolve discrepancies</li><li>Maintain detailed records of medical billing activities, including payment histories and correspondence</li><li>Ensure compliance with healthcare claims management regulations and insurance guidelines</li><li>Collaborate with healthcare providers to clarify documentation requirements and improve coding accuracy</li></ul>Requirements<ul><li>Proven experience in medical office administration or medical billing, with familiarity using billing software and EMR/EHR systems</li><li>Strong knowledge of medical terminology, medical records management, and medical coding standards including CPT, ICD-9, ICD-10, ICD coding, DRG, and healthcare claims management</li><li>Excellent customer service skills to assist patients with billing inquiries and insurance questions</li><li>Proficiency in Microsoft Office applications for documentation and reporting purposes</li><li>Understanding of health insurance policies, benefits verification, and medical collections processes</li><li>Ability to interpret complex medical data accurately while adhering to privacy regulations</li><li>Prior experience working with medical coding (medical coding certification preferred) and health insurance procedures is highly desirable</li></ul>Embrace this opportunity to advance your career in healthcare administration by leveraging your coding expertise, attention to detail, and commitment to excellent service. Join us in delivering seamless billing experiences that support quality patient care!Pay: $22.00 - $25.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Flexible schedule</li><li>Paid time off</li><li>Retirement plan</li></ul>Work Location: In person

PRN Physical Therapy

<div>Description
Job Title
Physical Rehabilitation Network (PRN) and its Family of Brands is seeking to recruit &amp; hire a Medical Account Receivable Specialist.
About Us
PRN brings together some of the most trusted PT brands across the West and Central U.S. Whether in the clinic or behind the scenes, we&rsquo;re all about personalized care, smart clinical insight, and making every patient feel supported from start to finish.
About the Role
If you LOVE working in the fast-paced environment of Revenue Cycle or Medical Billing from the comfort of your own home, then this might be an exciting opportunity for you. We are seeking an independent and extremely detail oriented Medical Account Receivable Specialist. The position is responsible for the full range of Payor follow up with different types of Payors.
Duties &amp; Responsibilities<ul><li>
Manage primary and secondary claims</li><li>
Respond promptly to billing inquiries from patients, insurance companies, and departments</li><li>
Work with clinics to identify and resolve issues regarding outstanding account balances</li><li>
Resolve denials and submit appeals</li><li>
Utilize the most efficient resources to secure timely payment of open claims</li><li>
Research assigned correspondence and take necessary action to resolve requests</li><li>
Ensure daily accomplishments contribute toward company goals for A/R</li><li>
Resolve accounts in follow-up queues</li></ul>
Skills &amp; Qualifications<ul><li>
High School/G.E.D. or equivalent combination of education and experience required</li><li>
2 years prior medical receivable collections experience preferred</li><li>
Understanding of medical claims processing</li><li>
Experience with insurance systems</li><li>
Knowledge of insurance including State and Federal rules and regulations as they relate to billing and collections</li><li>
Ability to understand claim denials/rejections</li><li>
Ability to read an Explanation of Benefits</li><li>
Knowledge of medical terminology</li></ul>
Benefits &amp; Perks
We offer a comprehensive and competitive compensation package designed to support both personal and professional well being. Team members enjoy full scale benefits&mdash;including robust Medical, Vision, and Dental plans&mdash;along with paid time off, clinical incentive opportunities, and student loan repayment options. We are committed to your continued growth and success, providing professional development resources and ongoing clinical education support.
At PRN, you&rsquo;ll be part of a supportive, mission driven environment dedicated to excellence in patient care and the success of every member of our team.
Note: This job description is a general outline of responsibilities and requirements. Specific duties may vary based on the needs of management.</div>

Medical Account Receivable Specialist

The Neurological Institute of Savannah

The Neurosurgical &amp; Spine Institute of Savannah is looking for an experienced Accounts Receivable (AR) Specialist to join our team!BenefitsOur practice prides itself on offering a competitive package for team members with a focus on wellness, retirement, and performance. Benefits available to our team members include:<ul><li>100% employer paid medical, prescription, and life insurance coverage for team members</li><li>Flexible Paid Time Off (PTO) program + paid holidays</li><li>401(k) Plan with a 50% match on up to 6%</li><li>Periodic performance bonuses including annual profit-sharing bonus that contributes to a team members potential retirement savings</li><li>Education and certification assistance</li><li>No cost for a variety of on-campus services for team members including consults, select labs, and imaging exams</li><li>Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans, and more</li></ul>AR Specialist Responsibilities:<ul><li>Actively works through list of denied claims by gathering the information needed to correct the claim or facilitate an appeal</li><li>Researches and understands issues specific to assigned payer(s) to troubleshoot the front-end processes that cause the denied claim</li><li>Taking pre-emptive measures to identify and keep practice up-to-date on any changes in billing requirements for assigned governmental and commercial payor</li><li>Monitoring assigned accounts for any repetitious registration/front end errors to support practice training efforts</li><li>Reviewing, researching, and resolving any claims that show no response back from the insurance by running reports and following the necessary steps to ensure that the claim gets processed</li><li>Promptly answering inquiries from patients, co-workers, and supervisors regarding patient accounts</li><li>Identifying which account balances are tied to patient responsibility and need to be reassigned to a patient billing specialist</li><li>Highlighting any credit balances caused by posting errors and or insurance / patient overpayments and submitting those to accounts receivable/payable for refund</li><li>Pinpointing delinquent accounts that need to be turned over to the appropriate agency for collection.</li><li>Clearly documenting all work within practice management system so others understand what follow-up and adjustments have occurred within the accounts touched</li></ul>Skills/Requirements:<ul><li>High school graduate or GED required</li><li>Additional billing and coding education preferred</li><li>Three (3) years&rsquo; experience in a revenue cycle department (charge entry, payment posting, pre-certification, collections, or billing) is required</li><li>One (1) year of experience in reviewing, researching, and resolving surgical claims is preferred</li><li>Clean background and credit history required</li></ul>Job Type: Full-timePay: $18.00 - $25.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee discount</li><li>Flexible schedule</li><li>Flexible spending account</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Ability to Commute:<ul><li>Savannah, GA 31405 (Required)</li></ul>Ability to Relocate:<ul><li>Savannah, GA 31405: Relocate before starting work (Required)</li></ul>Work Location: In person

Medical Billing/AR Specialist

Guardian Pharmacy

<div>Pink Hill, North Carolina, United States of America
Extraordinary Care. Extraordinary Careers.
With one of the nation&rsquo;s largest, most innovative long-term care pharmacy services providers, there is no limit to the growth of your career.
Southern Pharmacy Services, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Pink Hill, North Carolina.
Why Southern Pharmacy Services? We&rsquo;re reimagining medication management and transforming care.
Who We Are and What We&rsquo;re About:
Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.
We offer an opportunity to learn and grow your career in a fast-paced, diverse, and inclusive environment. If you are looking for a challenging, team-oriented environment in which you can put your expertise to work, then this is the place for you.
Regional Billing Specialist
Works directly with the Regional Billing Lead and Regional Billing Manager to execute various billing tasks for each of the pharmacy locations. Assisting in audit compliance, vaccine billing, Medicare open enrollment, ancillary billing charges, cost comparisons and other billing-related tasks.
Schedule Needed: (Remote)
Monday - Friday 8:00am-5:00pm
Attributes Required:
<ul><li>Work Ethic/Integrity &ndash; must possess intrinsic drive to excel coupled with values in line with company philosophy</li><li>
Strategy and Planning &ndash; ability to think ahead, plan and manage time efficiently</li><li>
Problem Solving &ndash; ability to analyze causes and solve problems at both a strategic and functional level with minimal direction</li><li>
Team Oriented &ndash; ability to work effectively and collaboratively with all team members</li><li>
Detail Oriented &ndash; ability to provide attention to detail</li><li>
Organizational &ndash; ability to organize work around multiple priorities and deadlines</li></ul>
Essential Job Functions (include the following):<ul><li>
Assist in researching, identifying and organizing documentation related to the timely processing of PBM audit requests for all SPS locations</li><li>
Assist in monitoring and executing all billing-related functions surrounding vaccine clinics</li><li>
Create ancillary revenue billing transactions according to contract and pharmacy performance at required intervals (monthly, quarterly, etc..)</li><li>
Participate in special enrollment and open enrollment activities as needed</li><li>
Perform new admission medication cost reviews as needed</li><li>
Provide customer service to internal and external customers as needed</li><li>
Update and process low income subsidies as needed</li><li>
Any other responsibilities as directed by supervisor</li></ul>
Education and/or Certifications:<ul><li>
High School diploma required, college degree in business preferred</li><li>
Pharmacy Technician registration required; National Certification preferred (PTCB)</li></ul>
Skills and Qualifications:<ul><li>
Excellent computer skills, including MS Office (Excel, Word, Teams)
</li><li>Excellent verbal and written communication skills; professional demeanor</li><li>
Strong attention to detail and analysis skills</li><li>
Ability to maintain confidentiality at all levels</li><li>
Ability to work to deadlines and balance multiple priorities</li><li>
Strong work ethic and desire to excel</li><li>
Pharmacy experience required</li><li>
Collections and Adjudication experience preferred</li><li>
FrameworkLTC and FrameworkECM experience required</li><li>
Strong knowledge of 3rd party insurance requirements</li><li>
Strong knowledge of pharmacy documentation requirements preferred</li></ul>
Work Environment:
<ul><li>Ability to work flexible hours</li></ul>
What We Offer:
Guardian provides employees with a comprehensive Total Rewards package, supporting our core value of, &ldquo;Treat others as you would like to be treated.&rdquo; 
 
Compensation &amp; Financial<ul><li>
Competitive pay</li><li>
401(k) with company match</li></ul>
Family, Health &amp; Insurance Benefits (Full-Time employees working 30+ hours/week only)<ul><li>
Medical, Dental and Vision
</li><li>Health Savings Accounts and Flexible Spending Accounts</li><li>
Company-paid Basic Life and Accidental Death &amp; Dismemberment
</li><li>Company-paid Long-Term Disability and optional Short-Term Disability</li><li>
Voluntary Employee and Dependent Life, Accident and Critical Illness</li><li>
Dependent Care Flexible Spending Accounts</li></ul>
Wellbeing<ul><li>
Employee Assistance Program (EAP)</li><li>
Guardian Angels (Employee assistance fund)</li></ul>
Time Off<ul><li>
Paid holidays and sick days</li><li>
Generous vacation benefits based on years of service</li></ul>
The Guardian Difference
Our clients require pharmacy services that aren&rsquo;t &ldquo;cookie cutter.&rdquo; That&rsquo;s why every Guardian pharmacy is locally operated and empowered with the autonomy to tailor their business to meet their clients&rsquo; needs.
Our corporate support offices, based in Atlanta, Ga., provide services such as human resources, business intelligence, legal, and marketing to promote the success of each Guardian location.
Regardless of your role at Guardian, your voice and talents matter. Because healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today&rsquo;s dynamic business environment.
At Guardian, we are dedicated to fostering and advancing a diverse and inclusive workforce.
Join us to discover what your best work truly looks like.</div>

Regional Billing Specialist

VITAS Healthcare

<div>Medical Billing Specialist is responsible for the complete and accurate billing and collections of all hospice claims submitted for payment to third party payers including, but not limited to, Medicare, Medicaid, Managed Care, commercial carriers, and any other state and federal health care programs. Performs all follow up duties associated with rebilling, adjustments, corrected claim submissions and collections of all overdue accounts/claims in accordance with best business practices. Must be able to work on-site in the Corporate Miramar, Florida office Monday-Friday. Hybrid schedule.
<ul>
<li>Meets established daily productivity standards.</li>
<li>Schedule and download the daily bill job files and processes for transmittal.</li>
<li>Research, correct, and re-submit rejected and denied claims.</li>
<li>Responsible for timely billing whether by paper or electronic claim in the appropriate claim format.</li>
<li>Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing.</li>
<li>Responsible for identifying problems and solutions or enhancements to resolve billing issues including, but not limited to, billing frequency, required forms, and general billing requirements.</li>
<li>Identify problem accounts and escalate as appropriate.</li>
<li>Update the patient account record to identify actions taken on the account.</li>
<li>Manages clearinghouse and payor accept/reject reports timely while ensuring all claim rejections are resolved within 72 hours of rejection occurrence.</li>
<li>Logs repetitive errors or exceptions and reports them to management to ensure the admission record and related systems are properly updated and corrected.</li>
<li>Coordinates with collectors and management to become familiar with the changing demands and requirements of payers in each state.</li>
<li>Interacts with other areas and departments to troubleshoot and resolve issues that may not have standard documented solutions.</li>
<li>Provide support to the Collectors by producing timely, accurate and complete billing documents.</li>
<li>Stays abreast of changes in all editing processes as may be required.</li>
<li>Acts as a resource for billing information and assists collectors and other staff members in producing any special documentation which may be required.</li>
<li>Identify coding or billing problems from EOBs and work to correct the errors in a timely manner.</li>
<li>Understands and serves and as subject-matter expert for billing specifications and requirements of assigned payers and states</li>
<li>Understand Hospice Notice of Election (NOE) submission timing requirements and exceptions.</li>
</ul>
QUALIFICATIONS
<ul>
<li>Three to four years prior experience in a general office environment (accounting or billing experience in a healthcare environment preferred)</li>
<li>Knowledge of insurance billing guidelines including Medicare, Medicaid, and other third party payers.</li>
<li>Possess a full understanding of the health care collections and reimbursement process, and an in depth knowledge of the insurance industry.</li>
<li>Ability to work on various assignments simultaneously</li>
<li>Strong interpersonal skills within all levels of the organization</li>
<li>Ability to navigate within automated systems and proficiency in Outlook, Word and Excel</li>
</ul>
EDUCATION
<ul>
<li>Completion of high school or basic education equivalency required.</li>
</ul>
SPECIAL INSTRUCTIONS TO CANDIDATES
<ul>
<li>EOE/AA M/F/D/V</li>
</ul>
VITAS&reg; Healthcare is the nation&rsquo;s leading provider of end-of-life care, and has the resources and expertise to support your personal and professional growth. As a member of the VITAS team, you&rsquo;ll find fulfillment working for a people-focused organization dedicated to making a difference in the lives of others. You will be more than just an employee: You will be counted on as an expert in your field, and as a valued team member whose efforts are respected and vital to our hospice mission.
All VITAS employees commit to fulfilling their duties and responsibilities with the highest regard for professionalism, collaboration and teamwork, and an eye focused constantly on growth and improvement. We serve with commitment and compassion, and position ourselves for the future by embracing, innovating, and leading change. If you are that person, make your voice heard&mdash;find your purpose at VITAS today.
Benefits Include:
<ul><li>Competitive compensation</li><li>Health, dental, vision, life and disability insurance</li><li>Pre-tax healthcare and dependent care flexible spending accounts</li><li>Life insurance</li><li>401(k) plan with numerous investment options and generous company match</li><li>Cancer and/or critical illness benefit</li><li>Tuition Reimbursement</li><li>Paid Time Off</li><li>Employee Assistance Program</li><li>Legal Insurance</li><li>Roadside Assistance</li><li>Affinity Program</li></ul> 
Many of our positions offer the opportunity to work day or night shifts, weekdays or weekends.
Choose a Career with VITAS</div>

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10000 senior medical billing specialist jobs Near Me

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