Medical Billing & Revenue Cycle Specialist

We are seeking a detail-oriented and experienced Medical Billing & Revenue Cycle Specialist to join our team. The successful candidate will be responsible for managing the complete revenue cycle process, ensuring accurate claim submission, timely reimbursement, denial resolution, and outstanding patient account management. This role requires strong knowledge of medical billing procedures, insurance regulations, and revenue cycle best practices.

Key Responsibilities:

Verify patient insurance eligibility, benefits, and authorizations.

Review and process medical claims accurately and efficiently.

Submit electronic and paper claims to insurance carriers.

Monitor claim status and resolve claim rejections and denials.

Perform accounts receivable follow-up on unpaid and underpaid claims.

Prepare and submit appeals for denied claims.

Post insurance and patient payments accurately.

Reconcile payments, adjustments, and write-offs.

Communicate with insurance companies regarding claim issues and payment discrepancies.

Respond to patient billing inquiries professionally and courteously.

Maintain compliance with healthcare regulations and payer requirements.

Generate billing, collections, and revenue cycle reports as required.

Identify opportunities to improve reimbursement and reduce denials.

Required Qualifications:

Minimum 2 years of experience in medical billing, revenue cycle management, or healthcare accounts receivable.

Strong understanding of medical billing processes and insurance claims.

Knowledge of ICD-10, CPT, and HCPCS coding systems.

Experience with Medicare, Medicaid, and commercial insurance billing.

Proficiency in medical billing software and electronic health record (EHR) systems.

Strong attention to detail and problem-solving skills.

Excellent verbal and written communication skills.

Ability to manage multiple priorities and meet deadlines.

Preferred Qualifications:

Certification such as CPB, CPC, CRCR, RHIT, or RHIA.

Experience with denial management and appeals.

Advanced Microsoft Excel skills.

Familiarity with healthcare practice management systems.

Key Competencies

Medical Billing & Coding

Revenue Cycle Management

Accounts Receivable Follow-Up

Claims Processing

Denial Management

Payment Posting

Insurance Verification

Analytical Thinking

Customer Service

Accuracy and Attention to Detail

What We Offer:

Competitive salary

Professional development opportunities

Supportive team environment

Career growth opportunities