We are seeking a detail-oriented and highly skilled Medical Billing Specialist to join our healthcare administration team. The ideal candidate will possess a strong understanding of medical billing processes, coding systems, and insurance claim procedures.

As a Medical Billing Specialist, you will be responsible for accurately processing medical claims, ensuring timely reimbursements, and maintaining comprehensive medical records. Your expertise in medical coding and familiarity with electronic health record (EHR) systems will be vital in supporting our organization’s financial health and compliance standards.

Responsibilities:

Review and interpret medical documentation to assign appropriate CPT (Current Procedural Terminology), and ICD-10 codes for billing purposes.
Prepare and submit accurate insurance claims using electronic billing systems while adhering to payer-specific guidelines.
Follow up on unpaid or denied claims through effective communication with insurance companies and patients to facilitate prompt resolution.
Ensure compliance with all relevant regulations, including DRG (Diagnosis-Related Group) coding standards and medical billing protocols.
Maintain detailed and organized medical records, including documentation of billing activities, adjustments, and collections.
Handle billing calls with patients and answer patient questions about statements.
Monitor accounts receivable to identify outstanding balances and implement collection strategies for overdue payments.
Stay current with updates in medical coding standards, insurance policies, and regulatory requirements to ensure ongoing compliance.

Qualifications:

Proven experience in medical billing, coding, or healthcare administration within a clinical or hospital setting.
Strong knowledge of DRG, CPT coding, ICD-10, and medical terminology essential for accurate billing processes.
Familiarity with EMR (Electronic Medical Records) and EHR (Electronic Health Record) systems used in healthcare facilities.
Experience in medical collections and resolving billing discrepancies efficiently.
Excellent attention to detail.
Effective communication skills for liaising with insurance providers, healthcare professionals, and patients.
Prior experience with medical office operations is preferred.