Medical Claims​/Collections Billing Specialist

Essential Duties & Responsibilities

• Review collection queues, Explanation of Benefits (EOBs), and correspondence for unpaid or underpaid claims.
• Research claim issues and resolve discrepancies appropriately.
• Interpret EOBs and insurance correspondence to determine required corrections or adjustments.
• Research exception reports and report findings to the Revenue Cycle Manager.
• Update patient and claim information by accessing internal and external systems.
• Resubmit corrected claims through billing systems as needed.
• Maintain accurate documentation, including MR notes, account status codes, and collection activity.
• Provide account updates and collection progress reports as requested.
• Assist patients with billing questions and payment processing.
• Process payments accurately using Z-Pay application.
• Assist in training staff on insurance processes and billing workflows when needed

• High School Diploma or equivalent required.
• Minimum of two (2) years of experience in medical accounts receivable or medical insurance claims processing.

• Strong knowledge of medical insurance billing and claims processing.
• Proficiency with MS Windows, RIS systems, and internal billing platforms (MI system).
• Ability to operate standard office equipment (computer, copier, fax, calculator, shredder).
• Strong attention to detail and accuracy in data entry and claims review.
• Ability to manage multiple tasks simultaneously and meet deadlines.
• Professional communication skills with patients, insurance companies, and coworkers.
• Ability to learn and adapt to multiple software systems.
• Strong written and verbal communication skills.
• Commitment to maintaining HIPAA compliance and protecting PHI.

Standard office environment.

Frequent computer and phone use.

Interaction with insurance companies, patients, and internal staff throughout the day.

• Ability to sit and work at a computer for extended periods.
• Ability to lift up to 20 lbs (files and paper boxes).
• Frequent use of hands for typing and data entry.