Medical Billing Specialist

Medical Billing Specialist
Work Location
Teays Valley, WV

Pay Rate
$17.00 per hour

Schedule
Monday – Friday
8:00 AM – 5:00 PM

Position Summary
The Billing Specialist is responsible for managing third-party and patient billing processes, ensuring accurate claim submission, payment posting, reimbursement tracking, and account resolution. This role works closely with insurance companies, healthcare providers, and patients to facilitate timely and accurate billing operations while maintaining compliance with payer requirements and organizational standards.

Qualifications

• High school diploma or equivalent required.
• Knowledge of medical billing and medical coding is required.
• Strong customer service and communication skills.
• Professional telephone etiquette.
• Proficiency with computers and billing software systems.
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.
• Ability to maintain confidentiality and handle sensitive information appropriately.

Essential Duties and Responsibilities

• Review provider documentation and billing data for accuracy before claim generation.
• Verify insurance information and payer-specific requirements, including authorizations, modifiers, and claim submission guidelines.
• Submit claims electronically to appropriate insurance carriers and payers.
• Investigate, review, and resolve denied or rejected claims promptly.
• Communicate with insurance companies, healthcare providers, and patients regarding billing, claims, and reimbursement issues.
• Utilize payer portals and websites to obtain claim status updates and process requests.
• Verify patient insurance eligibility and benefits.
• Accurately post payments and maintain payment batches.
• Assist patients with billing inquiries and account-related questions.
• Review, audit, and process documentation related to patient and payer refunds.
• Complete assigned weekly and monthly inbox reports within established deadlines.
• Review and work aging reports to ensure timely claim resolution and account follow-up.
• Maintain compliance with company policies, procedures, and applicable healthcare regulations.
• Perform additional duties and special projects as assigned.

Physical Requirements

• Regularly required to sit, speak, and hear.
• Frequent use of hands and fingers for keyboarding and data entry.
• Frequent standing, walking, reaching, and stooping.
• Ability to occasionally lift and/or move up to 25 pounds.
• Ability to maintain focus while working on detailed tasks for extended periods.
• Specific vision abilities include close vision, color vision, and the ability to adjust focus.

Benefits of Success in This Role
Successful candidates will demonstrate strong attention to detail, excellent customer service skills, effective problem-solving abilities, and a commitment to accuracy in all aspects of medical billing and reimbursement management.

Equal Employment Opportunity
Mountaineer Employment Solutions is committed to creating a diverse and inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic under applicable law.