Medical Billing and Revenue Cycle Specialist

What You’ll Do

• Manage insurance accounts receivable and follow up on unpaid, delayed, rejected, underpaid, or denied claims.
• Review claim status, payer responses, and account history to determine the appropriate next steps.
• Contact commercial insurance plans, Medicare, Medicaid, and managed care payers to research and resolve claim issues.
• Correct and resubmit claims when appropriate.
• Work claims involving eligibility, coordination of benefits, authorization, documentation, coding, provider enrollment, claim submission, reimbursement, or payer processing issues.
• Review explanations of benefits, electronic remittance advice, denial messages, and payer correspondence.
• Prepare and submit claim reconsiderations, corrected claims, or appeals when needed.
• Document all payer communication, follow-up activity, and resolution steps clearly and accurately.
• Identify recurring payer, provider, location, or claim-processing issues and escalate trends to leadership.
• Use Excel, billing-system reports, and internal tracking tools to organize follow-up and monitor outstanding accounts.
• Collaborate with billing, credentialing, clinical operations, providers, and leadership to support timely reimbursement and reduce preventable denials.
• Assist patients with billing questions, insurance concerns, balances, or account-related issues in a professional and respectful manner.
• Support payment research, patient balance review, claim corrections, and limited payment-posting functions as needed.
• Cross-train in additional medical billing and revenue cycle responsibilities as the organization grows.

What We’re Looking For

• At least two years of recent experience in medical billing, insurance follow-up, accounts receivable, denial management, payment posting, claims processing, or a related revenue cycle role.
• Experience in a physician practice, hospital-based practice, specialty group, medical billing company, health system, or similar healthcare setting.
• Working knowledge of the medical billing and insurance reimbursement process.
• Ability to research why a claim was rejected, denied, delayed, or underpaid and determine the appropriate action.
• Experience working with commercial insurance, Medicare, Medicaid, managed care, or other healthcare payers.
• Ability to read payer correspondence, claim status information, explanations of benefits, and electronic remittance advice.
• Professional communication skills when speaking with insurance representatives, patients, providers, and internal team members.
• Strong organization, documentation, time-management, and follow-through skills.
• Ability to manage multiple priorities and continue working an issue until it is resolved or appropriately escalated.
• Comfort learning new payer requirements, systems, workflows, and responsibilities.
• Experience using electronic medical record or practice-management software.
• Basic to intermediate Microsoft Excel skills.

Education

A college degree is not required. Relevant hands-on medical billing, insurance, claims, or revenue cycle experience is valued more heavily than formal education.

Professional billing or coding certifications are welcomed but are not required.

Additional information regarding company benefits will be discussed during the interview process.