Medical Hospital Billing Specialist

Job Title:

Medical Hospital Billing Specialist

Location:On-site / Hybrid / Remote
Department: Revenue Cycle / Patient Financial Services
Employment Type:Full-Time

The Medical Hospital Billing Specialist is responsible for accurate and timely billing of hospital services to insurance payers and patients. This role plays a critical part in the revenue cycle by ensuring claims are submitted correctly, payments are posted appropriately, and accounts are resolved efficiently while maintaining compliance with payer and regulatory requirements.

• Prepare, review, and submit hospital claims (inpatient, outpatient, and/or ancillary services) to commercial, Medicare, and Medicaid payers
• Verify patient insurance coverage, authorizations, and benefits as needed
• Ensure accurate charge capture, coding validation, and modifier usage prior to claim submission
• Monitor claim status and follow up on unpaid, denied, or underpaid claims
• Research and resolve claim denials, payment variances, and payer rejections
• Post payments, adjustments, and contractual allowances accurately
• Maintain detailed account notes and documentation in the billing system
• Communicate effectively with payers, patients, and internal departments to resolve billing issues
• Stay current on payer guidelines, billing regulations, and compliance requirements
• Meet productivity and accuracy standards established by the department

• High school diploma or equivalent required; associate’s degree preferred
• Minimum of 1–3 years of hospital billing experience required
• Strong knowledge of hospital billing processes, UB-04 claims, and payer guidelines
• Familiarity with CPT, HCPCS, ICD-10 coding concepts
• Experience with Medicare, Medicaid, and commercial insurance payers
• Proficiency with electronic health records (EHR) and billing systems
• Strong attention to detail and analytical skills
• Ability to manage multiple priorities and work independently
• Excellent written and verbal communication skills

• Experience in inpatient and outpatient hospital billing
• Knowledge of denial management and appeals
• Familiarity with revenue cycle metrics and AR follow-up workloads
• Certification such as CPB, CPC, or equivalent (preferred but not required)

• Collaborative, fast-paced healthcare environment
• Competitive compensation based on experience
• Comprehensive benefits package including medical, dental, vision, PTO, and retirement options
• Opportunities for professional growth and continuing education
• Applicants must be legally authorized to work in the United States. We are unable to sponsor or take over sponsorship of an employment visa at this time.