Medical Billing Specialist

Job Description:

As a Medical Billing Specialist, you will be responsible for ensuring accurate and timely submission of medical claims, patient billing, and payment collections for a pediatric clinic. You’ll work closely with healthcare providers and insurance companies to process claims, resolve billing issues, and optimize the revenue cycle for the clinic.

Responsibilities:

· Prepare and submit clean medical claims to insurance companies electronically and by paper.
· Ensure all claims are coded accurately using ICD-10, CPT, and HCPCS codes.
· Review and process insurance payments, denials, and follow-up on unpaid claims.
· Handle patient billing, send statements, and follow up on outstanding balances.
· Verify insurance coverage and benefits for patients.
· Coordinate with insurance companies to resolve billing issues and re-submit corrected claims as needed.
· Ensure compliance with federal and state regulations as well as HIPAA standards.
· Maintain accurate records of billing activities, payments, and adjustments.
· Work closely with front desk staff and providers to ensure proper coding and documentation for all services.
· Respond to patient billing inquiries and provide excellent customer service regarding account balances and payment plans.

Skills:
· Strong knowledge of medical billing processes, insurance claims, and coding (ICD-10, CPT).
· Experience with Electronic Health Records (EHR) and medical billing software (AthenaHealth preferred).
· Attention to detail and accuracy in data entry.
· Excellent organizational and multitasking skills.
· Strong communication skills, both written and verbal.
· Ability to work independently and as part of a team.
· Knowledge of HIPAA and other healthcare regulations.

Requirements:

· At least 1-2 years of experience in medical billing, preferably in a pediatric or family practice setting.
· Proficiency in medical coding and billing software.
· Understanding of various insurance plans (HMO, PPO, Medicaid, etc.)
· Ability to handle confidential information with discretion.

• Shift: US Shift (Fixed Shift)
• 5 Working Days