Job Summary
We are seeking a detail-oriented Medical Billing Specialist with a focus on Accounts Receivable to support our in-house revenue cycle operations. This role involves overseeing the full AR process for multiple Rural Health Clinics, including timely and accurate billing of Part A and Part B services. You'll be joining a collaborative, supportive team at our company headquarters.
Primary Responsibilities
Core duties emphasize Accounts Receivable functions across the entire billing cycle :
- Daily claim submission to insurance payers;
- Research and resolve denied, rejected, or no-response claims , including correction and appeals;
- Follow up on unpaid or underpaid claims in a timely and persistent manner to ensure resolution and maximize reimbursement;
- Maintain updated patient and insurance data in billing software to ensure claims are accurate and up to date;
- Collaborate with team leads and supervisors on reimbursement issues, trends in denials, or workflow improvements;
- Respond to requests for medical records and additional claim documentation as needed;
- Assist with reporting and documentation related to collections, AR trends, and key performance indicators (KPIs).
Qualifications
Required Experience :
Minimum 2 years of medical billing experienceStrong working knowledge of the full AR lifecycle within a healthcare settingEducation / Certification :
High school diploma or GED (required)Preferred certifications : CCS, CCSP, CPC, CPC-P, RHIA, COCPreferred : Associate degree or higher in Health Information Management, Healthcare Administration, or related fieldSkills and Competencies :
Proficient in billing both electronic and paper claimsStrong understanding of ICD-10, CPT / HCPCS coding , and modifier usageAbility to interpret insurance guidelines for Medicare, Medicaid, and commercial payersSkilled in EHR / EMR navigation , payor portals, and billing softwareStrong phone communication and problem-solving skills for working denials and collectionsFamiliarity with payor bundling / unbundling rules , medical necessity criteria, and common denial reasons