Medical Billing Specialist

We are seeking a detail-oriented and proactive Medical Billing & Insurance Reimbursement Specialist to manage insurance billing, monitor payments, resolve claim issues, and maximize reimbursement.

Responsibilities

• Review daily transactions and insurance payments to identify unpaid claims, underpayments, and payment discrepancies.
• Investigate and follow up on unpaid or underpaid claims to ensure accurate and timely reimbursement.
• Work insurance denials by identifying denial reasons, correcting billing errors, submitting appeals, and taking appropriate action to obtain payment.
• Negotiate insurance contract rates and reimbursement terms with insurance companies to improve payment rates, maximize revenue, and secure favorable contract terms.
• Prepare and submit insurance claims accurately and promptly.
• Communicate with insurance companies to resolve claim, payment, and coverage issues.
• Communicate with the employer promptly regarding billing issues, reimbursement problems, insurance changes, or other matters that may affect payment.
• Maintain accurate records and document all claim follow-ups, denial reasons, payment adjustments, and resolution actions.
• Monitor outstanding accounts receivable and follow up consistently to minimize revenue loss.
• Cross-cover other team members and perform additional duties as needed to support daily operations and maintain workflow continuity.

The ideal candidate takes ownership of their work, monitors claims and payments consistently, identifies reimbursement problems before they become significant losses, and follows through until issues are resolved.