Medical Billing & Claims Resolution Specialist

Protouch Staffing; Barnesville (OH); On-site; USD 25,000 - 39,000; Full time

Job summary

Protouch Staffing is seeking an experienced Medical Billing Specialist in Ohio to research and resolve denials, accurately post payments, and follow up on unpaid or incorrectly paid claims. You will submit claims, reconcile accounts, and provide billing support to providers and staff, while maintaining patient confidentiality.

The role requires knowledge of billing software, EMR/PM systems, and Medicare/workers' compensation processes, with a strong focus on accuracy and customer service.

Qualifications

• Basic knowledge of medical terminology.
• Previous medical billing and/or coding experience.
• Understanding of insurance claims processing, payment posting, denials, and claim reconciliation.
• Familiarity with Medicare billing and workers' compensation claims is preferred.
• Ability to learn and use Electronic Medical Records (EMR), Practice Management (PM) systems, and other billing software.
• Proficiency in standard office procedures, equipment, and computer applications.
• Strong organizational, analytical, and problem-solving skills.
• Excellent written and verbal communication skills.
• Strong attention to detail and accuracy in claim processing.
• Ability to manage multiple tasks and meet deadlines.
• Excellent customer service and interpersonal skills.

Responsibilities

• Research and resolve claim denials and rejections received from internal billing staff, insurance payers through Electronic Remittance Advice (ERA), and clearinghouses.
• Accurately post insurance payments, denials, and adjustments to patient accounts.
• Follow up on denied, rejected, unpaid, and incorrectly paid claims to ensure proper resolution.
• Submit claims through the MITS system when required.
• Split Medicare claims accurately according to applicable billing guidelines.
• Complete and fax required documentation for workers' compensation claims.
• Print and submit paper HCFA/CMS-1500 claims to insurance companies that do not accept electronic submissions.
• Reconcile patient accounts and insurance claims to ensure billing accuracy.
• Review claims for completeness and accuracy before submission.
• Attach supporting documentation to claims and prepare documentation for appeals when necessary.
• Contact insurance companies to resolve incorrect payments, claim discrepancies, missing payments, and copayment issues.
• Assist with posting remittance advice and deposits as needed.
• Respond to billing inquiries from patients, customers, and patient account representatives.
• Document all communications and follow-up activities related to patient accounts and claims.
• Assist front desk staff with insurance eligibility verification when needed.
• Provide billing guidance and support to providers, clinical staff, coding staff, and other billing team members.
• Maintain patient confidentiality and comply with applicable privacy requirements.
• Perform other related duties as assigned.

Skills

Medical terminology

Medical billing

Medical coding

Insurance claims processing

EMR/PM software

Attention to detail

Communication skills

Time management

Customer service

Professional demeanor

Teamwork

Confidentiality

Education

High school diploma or GED

Tools

EMR systems

Practice Management systems

Billing software

Job description

Protouch Staffing is seeking an experienced Medical Billing Specialist in Ohio to research and resolve denials, accurately post payments, and follow up on unpaid or incorrectly paid claims. You will submit claims, reconcile accounts, and provide billing support to providers and staff, while maintaining patient confidentiality.

The role requires knowledge of billing software, EMR/PM systems, and Medicare/workers' compensation processes, with a strong focus on accuracy and customer service.