About the Role
Job Description: Medical Billing Specialist
Overview
The Medical Billing Specialist is responsible for ensuring accurate and timely processing of billing activities, maintaining patient records, and supporting the overall revenue cycle. This role involves close collaboration with healthcare providers, insurance companies, and internal teams to maintain compliance, resolve discrepancies, and support smooth operations.
Key Responsibilities
Claims & Billing
Ensure accurate review and resolution of pending claims and billing discrepancies.
Maintain up-to-date and accurate patient information within records and databases.
Investigate claim denials and recommend corrective actions to secure reimbursement.
Verify patient insurance coverage and eligibility before claims submission.
Communicate professionally with insurance providers, patients, and facilities to gather necessary billing information.
Revenue Cycle & KPI Monitoring
Monitor and track monthly Key Performance Indicators (KPIs) related to billing and collections.
Participate in regular team meetings to address billing and revenue cycle issues.
Collaborate with colleagues to identify and implement process improvements in the revenue cycle.
Report and escalate errors or discrepancies found in billing processes.
Work with credentialing teams to stay updated on provider credential statuses.
Reconciliation & Reporting
Reconcile daily billing activities to ensure completeness and accuracy.
Perform timely and accurate data entry to update internal reports and productivity dashboards.
Review patient bills and coordinate with providers to resolve inaccuracies or missing information.
System & User Support
Manage user access and permissions for billing and practice management systems.
Provide basic troubleshooting and resolve user-reported issues to support daily operations.
Qualifications
Background in billing, healthcare administration, or related field preferred.
Strong attention to detail and accuracy in data entry and recordkeeping.
Effective communication and problem-solving skills.
Ability to work independently while collaborating with a team.
Basic technical aptitude for managing user access and resolving system issues.