Medical Billing & Insurance Specialist – High-Dollar Claims & Inpatient Billing (Hybrid, Full-T[...]

Medix™; Baltimore (MD); Hybrid; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Medical Billing & Insurance Specialist with expertise in high-dollar claims and inpatient billing. This full-time hybrid position involves managing complex claims and resolving insurance issues, requiring strong communication and problem-solving skills. Ideal candidates will have experience in hospital revenue cycle management and familiarity with billing systems.

Qualifications

• 1-2 years’ experience in hospital patient accounting, medical billing, or revenue cycle management.
• Experience managing high-dollar hospital accounts exceeding $100K in Maryland.
• Knowledge of Medicare Exhaust claims and COB processes.

Responsibilities

• Handle high-dollar inpatient facility claims for proper billing and reimbursement.
• Process Medicare Exhaust claims and resolve insurance claim denials.
• Collaborate with insurance companies for accurate claim processing.

Skills

Problem-Solving

Communication

Organizational Skills

Tools

Epic

Cerner

Meditech

Microsoft Office

Job description

Medical Billing & Insurance Specialist – High-Dollar Claims & Inpatient Billing (Hybrid, Full-Time) - 240427

Medical Billing & Insurance Specialist – High-Dollar Claims & Inpatient Billing (Hybrid, Full-Time) - 240427

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This salary range is provided by Medix. Your actual pay will depend on your skills and experience — discuss with your recruiter for more details.

Base pay range

$20.00/hr - $29.00/hr

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Job Description

We are seeking an experienced Medical Billing & Insurance Specialist with expertise in high-dollar hospital claims, Medicare Exhaust cases, and inpatient facility billing. Responsibilities include managing complex claims exceeding $100K in Maryland and $500K in Washington, DC, utilizing UB-04 billing, and resolving Coordination of Benefits (COB) conflicts. The ideal candidate will have extensive experience in hospital revenue cycle management, insurance appeals, and payer dispute resolution.

The position is full-time with a hybrid schedule: four days remote and one day in the office after training. All employees must work onsite for 5 days a week during the initial 3-4 months of training.

Key Responsibilities

1. Handle high-dollar inpatient facility claims, ensuring proper billing and reimbursement.
2. Process Medicare Exhaust claims, COB denials, and complex inpatient billing cases.
3. Investigate and resolve insurance claim denials, including appeals for underpayments and non-covered services.
4. Collaborate with insurance companies and hospital billing systems for accurate and timely claim processing.
5. Analyze payer trends and recommend corrective actions.
6. Complete daily UB-04 billing, ensuring compliance with hospital policies.
7. Meet benchmarks for claims resolution, denials management, and high-dollar claim collections.

Required Qualifications

1. Experience managing high-dollar hospital accounts exceeding $100K in Maryland and $500K in Washington, DC.
2. Knowledge of Medicare Exhaust claims, inpatient billing, and COB processes.
3. Proficiency with UB-04 billing for inpatient/hospital claims.
4. 1-2 years’ experience in hospital patient accounting, medical billing, or revenue cycle management.
5. Familiarity with hospital billing systems like Epic, Cerner, Meditech, and Microsoft Office.
6. Ability to resolve payer issues and follow up on unpaid claims.
7. Strong communication, organizational, and problem-solving skills.

Job Type & Schedule

1. Full-time hybrid position: four days remote, one day in-office.
2. Initial onsite work for 5 days a week during training (first 3-4 months).

If qualified, apply today to impact hospital revenue cycle operations!