Medical Billing Specialist

The Medical Billing Specialist is responsible for reviewing daily charges and adjustments for accuracy, filing third-party claims, managing self-pay patient billing, and responding to billing questions from patients and staff.

Primary Responsibilities

• Review assigned claims daily prior to submission.
• Verify documentation on self-pay claims and apply appropriate discounts.
• Make billing corrections and adjustments to support prompt payment and accurate balances.
• Validate payer information and verify patient eligibility when needed.
• Contact patients for missing information or clarification.
• Request, scan, and upload documentation needed to process claims.
• Submit claims to the clearinghouse daily.
• Process secondary and tertiary claims accurately and on time.
• Assist with denied claims, credit balances, rejection, and rebill requests.
• Follow up on pending claims through resolution.
• Help patients with balance and benefit questions, including deductibles and co-payments.
• Coordinate payment arrangements and issue statements when needed.
• Support front office staff with billing and eligibility questions.
• Produce itemized bills and process invoices as needed.
• Create daily deposit slips and post credit card payments.
• Maintain compliance with Medicare, Medicaid, and HIPAA guidelines.
• Support special projects and other assigned duties.