Medical Billing Specialist

Medical Billing Specialist

A well-established nonprofit organization in Shelton is seeking a Medical Billing Specialist to support its growing healthcare operations. This role is ideal for a detail-oriented individual who enjoys working in a mission-driven environment and has experience managing the full medical billing cycle. The Medical Billing Specialist will play a key role in ensuring timely and accurate billing, claims processing, payment posting, and revenue cycle support.

Key Responsibilities:

• Process and submit medical claims to Medicare, Medicaid, managed care organizations, and commercial insurance providers.
• Review claims for accuracy and completeness prior to submission.
• Monitor claim status and proactively follow up on denied, rejected, or unpaid claims.
• Research and resolve billing discrepancies, payment variances, and reimbursement issues.
• Post insurance and patient payments accurately and reconcile accounts.
• Manage accounts receivable aging and conduct collection activities as needed.
• Verify patient insurance eligibility and benefits.
• Work closely with providers, clinical staff, and leadership to resolve billing concerns and improve reimbursement processes.
• Maintain compliance with payer guidelines, HIPAA regulations, and organizational policies.
• Assist with reporting, audits, and month-end revenue cycle activities.