Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to support healthcare claims and reimbursement activities in Bloomington, Minnesota. This role focuses on preparing, submitting, and tracking billing for a range of home and community-based services while helping ensure claims are accurate, timely, and fully supported by required documentation. The ideal candidate brings strong knowledge of medical billing workflows, payer requirements, and follow-up practices that improve cash flow and resolve claim issues efficiently.

Responsibilities:

• Examine service records, authorizations, care plans, and supporting documents to confirm claims are ready for submission to Minnesota Medical Assistance and other applicable payers.

• Process and track claims for home care and related community-based services using payer portals, clearinghouses, and revenue cycle platforms.

• Investigate unpaid, denied, rejected, underpaid, or recouped claims and take appropriate action to secure correct reimbursement.

• Conduct account reviews for aged receivables, including outstanding balances over 30 days, and document follow-up activity in assigned tracking tools.

• Analyze remittance information to identify payment variances, denials, adjustments, spend-down impacts, and reimbursement discrepancies.

• Resolve billing exceptions by correcting claim details and submitting original, replacement, corrected, or voided claims in line with payer rules.

• Review unbilled service lines regularly to ensure eligible charges are captured and submitted without unnecessary delay.

• Respond to billing-related questions from internal teams and external partners, including payers, case managers, coordinators, and other stakeholders.

• Maintain compliance with state and federal billing standards, documentation expectations, coding requirements, confidentiality obligations, and fraud prevention guidelines.

• Escalate high-risk account concerns, authorization mismatches, documentation deficiencies, database inaccuracies, and payer-related barriers to leadership when needed.

Qualifications:

• Experience in medical billing, claims processing, or healthcare revenue cycle operations.
• Working knowledge of insurance billing practices, remittance review, and denial resolution.
• Ability to manage billing activity across multiple payer types, including government-funded and managed care programs.
• Familiarity with computerized billing systems, clearinghouses, and online payer portals.
• Strong attention to detail with the ability to verify documentation, authorizations, and coding accuracy.
• Effective written and verbal communication skills for handling billing inquiries and coordinating with internal and external contacts.
• Ability to organize workload, prioritize follow-up tasks, and meet productivity goals in a deadline-driven environment.
• Understanding of confidentiality standards and compliance expectations within a healthcare setting.

Compensation

$50,000.00-$65,000.00 Yearly

About Us

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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