Medical Billing Specialist

Job Summary

Handling a variety of payment collection activities, the full-time Medical Billing Specialist will manage appealed claims, communicate with insurance plans, and resolve billing issues while working remotely.

Key responsibilities

• Conduct collection activities on appealed claims by contacting relevant parties
• Review contracts and identify billing or coding issues, requesting necessary corrections
• Research health plans for benefits and types of coverage while providing ongoing collection support

Required qualifications

• Thorough understanding of the revenue cycle process and Managed Care collections
• Familiarity with terms such as MMC, HMO, PPO, IPA, and Capitation
• Knowledge of Managed Care contracts and Federal and State requirements
• Intermediate understanding of hospital billing form requirements (UB04) and HCFA 1500
• Minimum high school education with technical training or related experience