Medical Billing Specialist

We are looking for a Medical Billing Specialist to support revenue cycle operations for a healthcare team in Richmond, Virginia. This contract-to-permanent position is ideal for someone who can manage insurance billing activity, resolve claim issues efficiently, and maintain a strong focus on reimbursement accuracy and patient service. The role requires close attention to account follow-up, timely claims processing, and effective communication with insurance representatives and patients when needed.

Responsibilities:
• Monitor aged accounts and take action on patient balances beginning at 60 days from the date of service, using accounts receivable reports to drive timely follow-up.
• Submit primary and secondary insurance claims through electronic billing systems on a daily basis to support prompt payment.
• Examine claims for accuracy and completeness, making corrections as needed before resubmission.
• Investigate and resolve rejected, returned, denied, or partially paid claims within five business days to reduce delays in reimbursement.
• Prepare and send rebilled claims and route them to the correct insurance carrier based on coverage details.
• Draft and submit appeals for claim denials, ensuring supporting documentation and written communication are clear and thorough.
• Research payer-related issues, including eligibility concerns, network limitations, workers' compensation matters, and other claim processing obstacles.
• Communicate with insurance carriers and third-party representatives to move claims toward resolution and reconcile outstanding account activity.
• Track unresolved or suspended claims, provide status updates, and report weekly productivity results to leadership.

Qualifications:

• At least 2 years of experience in medical billing, insurance reimbursement, account collections, coding, and medical terminology.
• Additional experience in a medical office or billing setting, ideally 4 to 5 years, is strongly preferred.
• Working knowledge of medical claims processing, including denials management, rebills, account reconciliation, and appeals.
• Ability to verify and explain insurance eligibility, billing details, coding-related information, and payer requirements.
• Proficiency with Microsoft Excel and Microsoft Word.
• Strong customer service and communication skills when working with patients, payers, and internal teams.
• High school diploma or equivalent is required.
• Certification and experience with eClinicalWorks are considered an advantage.

Compensation

$23.00-$24.00 Hourly

About Us

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