Medical Billing & Claims Specialist: AR & Denials

Southern Colorado Clinic, PC; Pueblo (CO); On-site; USD 38,000 - 52,000; Full time

Benefits offered by this job

Job summary

Southern Colorado Clinic, PC is seeking a full-time Medical Biller to join our Pueblo, CO team. The role covers all aspects of medical claims billing and accounts receivable, ensuring accurate submission, denial management, and timely payments in a busy clinic setting.

The ideal candidate will have healthcare billing experience, CPT/ICD-10 knowledge, and proficiency with EMR systems, while maintaining high ethical standards and patient confidentiality in a non-remote environment.

Qualifications

• High School Diploma or equivalent required.
• Billing Certification preferred.
• Knowledge of provider health insurance and the health insurance industry.
• Proven experience in healthcare billing and coding and associated regulations.
• Proficiency in filing and collecting insurance claims for individual carriers or agencies.
• Knowledge of CPT and ICD-10 coding and clinic operating policies.
• Knowledge of medical terminology.
• Ability to multitask.
• Strong ethical code of conduct.
• Ability to maintain sensitive confidential information.
• Proficiency with computers and EMR software.
• Autonomous, positive mindset and team player.
• Ability to remain motivated with a positive attitude.
• Disciplined, organized, and detail oriented.
• Willingness to learn and adapt.
• Ability to work with all levels of management and staff in a professional capacity.

Responsibilities

• Submit corrected claims and follow up on appeals and denials.
• Resubmit insurance claims that have received no response or are not on file and ensure claims are paid and processed according to Clinic contract.
• Assist with error resolution.
• Maintain required billing records, reports, and/or files.
• Post all credit and debit adjustments to patient accounts with strict adherence to the company guidelines.
• Continually work accounts receivable to ensure prompt payment for services rendered.
• Provide customer service both on the telephone and in the office for all patients and authorized representatives regarding patient accounts in accordance with practice protocol.
• Follow‑up on all outstanding insurance claims at 60 days from the date of service in accordance with business office protocol with an emphasis on maximizing patient satisfaction and practice profitability.
• Follow‑up on all returned claims correspondence, denials, account reconciliations, and rebills.
• Process refunds to insurance companies and patients in accordance with billing office protocol.
• Establish payment plans with patients within approved guidelines.
• Adhere to all practice policies related to HIPAA, CMS Compliance, and OSHA.
• Perform patient education when appropriate.
• Maintain work area in a clean, sanitized, and organized manner.
• Follows all Infection Prevention policies and procedures.
• Attends annual required company programs and training.
• Attends all regular required department and company meetings.
• Maintains strictest confidentiality.
• Performs all other tasks and projects assigned

Skills

Billing experience

CPT/ICD-10 coding

EMR software

Healthcare billing

Multitasking

Customer service

Education

High school diploma

Billing Certification preferred

Tools

EMR software

Job description

Southern Colorado Clinic, PC is seeking a full-time Medical Biller to join our Pueblo, CO team. The role covers all aspects of medical claims billing and accounts receivable, ensuring accurate submission, denial management, and timely payments in a busy clinic setting.

The ideal candidate will have healthcare billing experience, CPT/ICD-10 knowledge, and proficiency with EMR systems, while maintaining high ethical standards and patient confidentiality in a non-remote environment.