Medical Billing Specialist

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a mission-focused nonprofit organization in Spring, Texas. This contract opportunity with permanent potential is ideal for someone who brings strong Medicaid billing knowledge and wants to support services that positively impact individuals with a wide range of care needs. In this role, you will help protect revenue by ensuring claims are accurate, compliant, and followed through to resolution.

You will work closely with internal teams to improve reimbursement outcomes while maintaining high standards of accuracy and regulatory compliance.

Responsibilities:

• Review patient and client coverage information to confirm Medicaid and other insurance eligibility before billing activity begins.
• Prepare and submit Medicaid claims with complete and accurate coding, modifiers, provider identifiers, and supporting billing details to reduce processing issues.
• Track claims throughout the reimbursement cycle and address unpaid, denied, delayed, or partially paid balances in a timely manner.
• Investigate denial trends, determine underlying causes, and complete appeals or corrected claim submissions to support payment recovery.
• Interpret remittance documents, explanation of benefits statements, and payer correspondence to resolve claim discrepancies.
• Use payer portals and available resources to verify claim status, identify denial reasons, and document next steps for resolution.
• Partner with operational and clinical teams to clarify billing questions and strengthen overall claim quality and reimbursement performance.
• Stay informed on Texas Medicaid requirements, managed care plan expectations, and applicable state and federal billing regulations.
• Maintain organized records and support audit readiness by following internal policies and established compliance standards.