Medical Billing Specialist

Responsible for premium billing operations for the organization. This role provides technical support to the accounting department and handles complex billing issues related to policy-holders and insurance carriers.

The position troubleshoots eligibility problems that prevent accurate billing, researches premium payment errors, and handles collection matters as needed. It also collaborates with internal team members and vendors, provides customer service, and uses strong decision-making skills in a team environment.

Key responsibilities include reviewing and organizing contractor documents for monthly billing, performing billing data entry, transmitting electronic claim files to the clearinghouse, mailing paper claims and reconsideration forms, reconciling monthly billing and posting payments, resolving discrepancies and denials, following up on delinquent insurance claims, correcting clearinghouse errors, serving as a liaison with clients and payers, compiling audit reports, and conducting coding training sessions for providers.