Medical Billing Specialist

United StatesRemoteFull-timemid

OtherMedical Billing Specialist

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Quick Summary

Key Responsibilities

High school diploma or equivalent required. Previous professional experience in charge entry, medical billing, or medical coding required; experience in an oncology healthcare setting is preferred.

Technical Tools

OtherMedical Billing Specialist

As a Medical Billing Specialist, you’ll play an essential role in ensuring accurate and timely charge capture within a healthcare revenue cycle. You’ll work closely with clinical teams and revenue cycle management colleagues to review charges, resolve discrepancies, and maintain accurate billing records. The role requires strong knowledge of medical coding, insurance billing, reimbursement processes, and payer requirements. You’ll review medical records and billing reports to ensure diagnoses, procedures, modifiers, and other required information are correctly captured. Attention to detail and analytical thinking will be critical when addressing claim edits, rejections, denials, and other billing issues. You’ll work independently while contributing to a collaborative, patient-focused healthcare environment. This is a fully remote position with opportunities to strengthen billing processes and support high-quality operational performance.

Review, audit, and adjust charges from interfaced files to ensure accurate and timely charge capture.
Manually enter and audit specialized charges, including pathology, molecular testing, psychology, genetic counseling, and other services, while communicating outstanding items or questions to clinical staff.
Run and review billing reports to confirm that all required information has been received and accurately recorded in the practice management system.
Create daily charge files from laboratory application software to support complete and accurate charge capture.
Reconcile scheduled appointments against posted charges and identify missing or outstanding billing information.
Collaborate with clinical staff and revenue cycle management teams to resolve charge-posting issues and maintain timely billing workflows.
Review medical records when necessary to validate diagnoses, procedures, modifiers, and coding accuracy.
Apply knowledge of billing guidelines, medical policies, payer requirements, and reimbursement regulations to assigned billing activities.
Work daily on assigned tasks related to claim edits, rejections, denials, collections, and other revenue cycle issues, driving each item through to resolution.
Identify, manage, and resolve tickets across various statuses within the practice management system.
Maintain working knowledge of HCPCS, ICD, and CPT oncology coding and applicable insurance carrier requirements.
Follow established policies and procedures to support consistent and standardized billing processes.
Participate in training and knowledge-sharing activities as assigned to strengthen individual and team capabilities.
Demonstrate ownership, professionalism, and a collaborative mindset while managing responsibilities independently.
Perform additional duties as assigned in support of efficient healthcare operations and patient care.

Requirements

~1 min read

High school diploma or equivalent required.
Previous professional experience in charge entry, medical billing, or medical coding required; experience in an oncology healthcare setting is preferred.
Strong knowledge of medical billing, HCPCS, CPT, and ICD coding.
Expertise in insurance policies and reimbursement requirements, including Medicare, Medicaid, and commercial insurance plans.
Understanding of medical billing guidelines, payer requirements, medical policies, and insurance reimbursement processes.
Strong analytical skills and the ability to review complex billing information accurately.
Exceptional attention to detail, organization, and multitasking abilities.
Ability to manage assigned deadlines while maintaining accuracy and productivity.
Strong written and verbal communication skills, including active listening and the ability to communicate findings and recommendations effectively.
Ability to work collaboratively with clinical staff, revenue cycle teams, management, and other colleagues.
Demonstrated initiative, mature judgment, adaptability, and a strong customer-service orientation.
Ability to work autonomously while contributing effectively to a team-oriented environment.
Proficiency with Windows-based applications, including Microsoft Word, Outlook, Excel, and similar tools.
Reliable attendance and consistent productivity are essential to meeting role objectives.