A billing specialist ensures accurate financial reimbursement for medical services by submitting insurance claims (CMS-1500/UB-04), verifying eligibility, and managing denials. They resolve billing issues, communicate with payers and patients, review remittance forms to verify proper reimbursement, and maintain compliance with HIPAA.
Key Responsibilities
- Scrub, prepare, and submit clean, accurate claims to insurance providers such as Medicaid and private insurers.
- Confirm patient eligibility and benefits.
- Research, appeal, and resolve denied or rejected claims.
- Post payments and reconcile accounts as part of revenue cycle management.
- Contact patients for additional information or confirmation of information.
Common Performance Metrics
- Daily, weekly, and monthly production goals, such as the number of claims processed.
- Reduction of days in Accounts Receivable (A/R).
- Accuracy of claim submission to reduce denial rates.
Physical Requirements
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift up to fifteen pounds at times.
Requirements & Qualifications
Required Skills & Qualifications
- Proficiency with electronic health records (EHR) and billing software.
- Strong verbal communication skills and hearing ability to discuss billing with medical staff, patients, and Medicaid staff.
- Basic math skills to calculate and identify discrepancies.
- Strong attention to detail and analytical ability for identifying billing errors and reviewing patient accounts.
- Organizational skills and the ability to establish priorities.
- High school diploma or GED required.
- 2+ years of experience in a medical office setting preferred.
Benefits & Perks
Benefits
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Location
Oklahoma, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago