Medical Billing & Claims Specialist
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Job Description
Medical Billing & Claims Specialist processing medical procedure claims for a U.S.-based allergy and immunology practice. Managing denials, resubmissions, reimbursement, and billing records.
Responsibilities:
- Post and process medical claims accurately and efficiently
- Manage claims for medical procedures from submission through resolution
- Review claims for completeness and accuracy before processing
- Maintain accurate posting and billing records
- Manage a consistent daily volume of claims while maintaining quality and accuracy
- Track claim status and follow up on outstanding claims
- Ensure claims are processed according to established billing and compliance requirements
- Review and work denied or rejected claims
- Identify reasons for denials and take corrective action
- Resubmit or follow up on claims as necessary
- Work toward successful claim overturns and reimbursement
- Document denial actions and claim follow-up accurately
- Identify recurring billing or denial issues
- Provide billing support to the existing in-house billing team
- Assist with complex billing scenarios, including multiple patient reimbursements
- Review payer information and billing documentation
- Maintain organized and accurate billing records
- Follow compliance and confidentiality requirements
- Assist with additional billing-related responsibilities as assigned
- Work toward at least 80 claims posted per day and approximately 85–90% successful resolution/payment of worked claims
Requirements:
- Minimum 2–3 years of medical billing experience
- Hands-on claims posting experience is required
- Strong experience managing claims for medical procedures is required
- Experience working denied and rejected claims through resolution
- Strong understanding of the medical billing and claims lifecycle
- Ability to investigate claim issues and determine appropriate next steps
- Experience handling complex billing scenarios
- Strong understanding of billing accuracy, compliance, and confidentiality requirements
- Ability to manage a high volume of claims while maintaining accuracy
- Strong attention to detail and organizational skills
- Able to work independently and consistently meet productivity expectations
- Clear and professional written and spoken English
- Reliable, accountable, and comfortable working as part of an established billing team
- Must speak and write English clearly and professionally
- Must have relevant work experience
- Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory)
- Must be available to attend video meetings with camera on when required
- Reliable laptop or desktop computer
- Stable high-speed internet connection (minimum 25 Mbps)
- Noise-canceling headset
- Working webcam for virtual meetings
- Quiet and professional work environment
Benefits:
- Dedicated HR & Contractor Support Team
- Premium VPN Access (Optional)
- HIPAA & Cybersecurity Training + Certification (Provided)
- Top 1% VA Performance Training
- Client-Approved U.S. Holidays
- Client-Approved Paid or Unpaid Time Off
- Access to Tools & Resources
- Optional Performance-Based Incentives
- Optional bonuses, incentives, or increased hours based on performance
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