Medical Billing Specialist

Accounts Billing Specialist I

Join a dedicated healthcare team in the heart of the Midwest region, where your role as a Billing Specialist I is vital to the smooth operation of patient billing and insurance claims processing. This full-time position involves managing claims entry, insurance follow-up, and patient account inquiries with accuracy and care.

As a Billing Specialist I, you will be responsible for entering and submitting insurance claims, posting insurance payments, and addressing patient questions regarding their accounts. You will report directly to the Billing Supervisor and play a key role in ensuring claims are complete, accurate, and timely.

Essential duties and responsibilities include:

• Enter patient and insurance information necessary for claims submission.
• Ensure all claim data is accurate and complete before submission.
• Submit claims electronically or via paper forms such as UB04 and CMS-1500.
• Respond to patient inquiries about copays, deductibles, write-offs, and account balances.
• Follow up on unpaid or rejected claims with insurance companies and resubmit as needed.
• Prepare appeal letters for denied claims, gathering all necessary documentation.
• Adhere strictly to HIPAA guidelines when handling patient information.
• Perform soft collections by contacting patients regarding past due accounts through phone or mail.
• Verify patient benefits eligibility and understand managed care authorizations and coverage limits.
• Submit secondary claims after primary insurer processing.

Education: High School Diploma or GED is required.

Experience: Previous medical billing experience is highly preferred. Familiarity with billing software and electronic data submission is advantageous.

Mental/Physical Requirements: Ability to communicate detailed information clearly, maintain concentration during repetitive tasks, and read and understand written instructions. Physical ability to stand, walk, sit, reach, and occasionally lift items up to 10 pounds.

Working Conditions: Standard office environment with occasional exposure to noise, fumes, chemicals, and other hazards.