Medical Billing Specialist

Little Rock Specialty Clinic looking for an additional Medical Billing Specialist to join their team.

The Medical Billing Specialist is responsible for managing the billing and claims process to ensure accurate and timely submission of medical claims to insurance companies and government payers. This position works closely with physicians, clinical staff, insurance companies, and patients to resolve billing issues, obtain reimbursement, and maintain accurate patient accounts while ensuring compliance with healthcare regulations and billing guidelines.

Essential Duties and Responsibilities

- Review patient accounts, insurance information, and medical documentation for accuracy.

- Prepare, review, and submit medical claims to commercial insurance companies, Medicare, and Medicaid.

- Verify insurance eligibility and benefits.

- Review CPT, ICD-10, and HCPCS codes for accuracy and completeness.

- Follow up on unpaid, denied, and rejected insurance claims.

- Research and resolve billing discrepancies and claim denials.

- Post insurance payments, adjustments, and patient payments.

- Process appeals and corrected claims when necessary.

- Communicate with insurance representatives regarding claim status and reimbursement.

- Maintain accurate billing records and documentation.

- Assist with accounts receivable follow-up and aging reports.

- Ensure compliance with HIPAA, CMS guidelines, and payer-specific billing requirements.

- Provide professional customer service when addressing patient billing questions.

- Identify trends in claim denials and recommend process improvements.

Qualifications and Requirements

- High school diploma or equivalent required.

- Medical billing and coding experience preferred.

- Knowledge of medical terminology and healthcare reimbursement processes.

- Familiarity with ICD-10, CPT, and HCPCS coding.

- Experience with Medicare, Medicaid, and commercial insurance billing.

- Knowledge of HIPAA regulations and CMS billing guidelines.

- Strong computer, communication, and organizational skills.

- Ability to multitask and meet billing deadlines.

- Attention to detail and problem-solving skills.

Preferred Skills

- Experience with electronic health records (EHR) and practice management systems.

- Knowledge of claims processing and revenue cycle management.

- Experience with insurance denials and appeals.

- Understanding of CMS documentation and billing requirements.

Performance Expectations

- Maintain accurate and timely claim submissions.

- Reduce claim denials and billing errors.

- Maintain appropriate accounts receivable follow-up.

- Ensure timely resolution of outstanding claims.

- Maintain confidentiality and compliance with all regulatory requirements.