We are looking for a detail-oriented Medical Billing Specialist to support healthcare claims and reimbursement activities in Bloomington, Minnesota. This role focuses on preparing, submitting, and tracking billing for a range of home and community-based services while helping ensure claims are accurate, timely, and fully supported by required documentation. The ideal candidate brings strong knowledge of medical billing workflows, payer requirements, and follow-up practices that improve cash flow and resolve claim issues efficiently.
- Examine service records, authorizations, care plans, and supporting documents to confirm claims are ready for submission to Minnesota Medical Assistance and other applicable payers.
- Process and track claims for home care and related community-based services using payer portals, clearinghouses, and revenue cycle platforms.
- Investigate unpaid, denied, rejected, underpaid, or recouped claims and take appropriate action to secure correct reimbursement.
- Conduct account reviews for aged receivables, including outstanding balances over 30 days, and document follow-up activity in assigned tracking tools.
- Analyze remittance information to identify payment variances, denials, adjustments, spend-down impacts, and reimbursement discrepancies.
- Resolve billing exceptions by correcting claim details and submitting original, replacement, corrected, or voided claims in line with payer rules.
- Review unbilled service lines regularly to ensure eligible charges are captured and submitted without unnecessary delay.
- Respond to billing-related questions from internal teams and external partners, including payers, case managers, coordinators, and other stakeholders.
- Maintain compliance with state and federal billing standards, documentation expectations, coding requirements, confidentiality obligations, and fraud prevention guidelines.
- Escalate high-risk account concerns, authorization mismatches, documentation deficiencies, database inaccuracies, and payer-related barriers to leadership when needed.
- Experience in medical billing, claims processing, or healthcare revenue cycle operations.
- Working knowledge of insurance billing practices, remittance review, and denial resolution.
- Ability to manage billing activity across multiple payer types, including government-funded and managed care programs.
- Familiarity with computerized billing systems, clearinghouses, and online payer portals.
- Strong attention to detail with the ability to verify documentation, authorizations, and coding accuracy.
- Effective written and verbal communication skills for handling billing inquiries and coordinating with internal and external contacts.
- Ability to organize workload, prioritize follow-up tasks, and meet productivity goals in a deadline-driven environment.
- Understanding of confidentiality standards and compliance expectations within a healthcare setting.
Robert Half offers access to top jobs, competitive compensation and benefits, and free online training. Benefits available to contract/temporary professionals include medical, vision, dental, and life and disability insurance, plus eligibility to enroll in a 401(k) plan.
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$50,000 - $65,000
Remote work allowed
No
Posted
4 weeks ago