Medical Billing Specialist

Medical Billing Specialist – Mile Bluff Medical Center

** Schedule**:
Full‑time, 80 hours per pay period (Monday – Friday, 8:00 am – 4:30 pm). Position is not eligible for remote work; must report on‑site daily.

** Weekend rotation**:
None

* Holiday rotation*:
None

The Medical Billing Specialist accurately prepares, submits, and follows up on medical claims to insurance companies and patients. The role ensures timely reimbursement, compliance with healthcare regulations, and effective communication with providers, payers, and patients.

• Prepare, submit, and transmit clean medical claims to commercial, Medicare, and Medicaid payers (electronic and paper).
• Review and resolve accounts and pre‑claim edits.
• Verify patient insurance coverage and benefits.
• Review documentation and charges for accuracy and compliance.
• Monitor accounts receivable and follow up on outstanding balances.
• Follow up on unpaid, denied, or rejected claims and resolve billing issues.
• Review and reconcile account credit balances.
• Identify and correct billing errors to prevent claim rejections.
• Communicate with coding, denial management specialists, insurance companies, patients, clinical staff, and healthcare providers regarding billing inquiries to ensure accurate charges, billing, and reimbursement.
• Maintain compliance with HIPAA, Medicare, Medicaid, and payer guidelines.
• Assist with patient billing questions and patient payments.
• Interpret EOBs and remittance advice.
• Maintain accurate billing records and documentation.
• Support audits and compliance initiatives when required.
• Perform other duties as requested.

• High school diploma or equivalent required.
• 1+ years of related work experience required.
• Experience working in the medical industry preferred.
• Familiarity with insurance guidelines, EOBs, and claim adjudication processes.
• Proficiency with electronic health records (EHR) and billing software.
• Exceptional accuracy and attention to detail required.

• Intermediate proficiency with computers required.
• Experience in insurance claims required.
• Knowledge of CPT, ICD‑10, and HCPCS coding systems.
• Strong quantitative and analytical competency.
• Self‑starter with excellent interpersonal communication and problem‑solving skills.

Entry level

Full‑time

Health Care Provider

Hospitals and Health Care