Medical Billing Representative

Carolinadigestive; Charlotte (NC); On-site; USD 40,000 - 60,000; Full time

Job summary

An established industry player is seeking a detail-oriented Medical Billing & Collections Representative to enhance their healthcare team. This role involves managing medical claims, resolving outstanding balances, and ensuring timely payments from insurance providers. The ideal candidate will possess strong organizational skills, attention to detail, and excellent communication abilities, enabling them to navigate complex insurance processes efficiently. Join a supportive environment where your contributions will significantly impact patient care and financial operations.

Qualifications

• Experience in medical collections and billing in a healthcare setting.
• Strong knowledge of medical billing codes and insurance policies.

Responsibilities

• Process medical claims and manage patient accounts effectively.
• Investigate and resolve billing discrepancies with patients and insurers.

Skills

Medical Billing

Collections

Communication Skills

Problem-Solving

Organizational Skills

Education

High School Diploma

Associate Degree in Medical Billing and Coding

Tools

Medical Billing Software

Electronic Health Records (EHR)

Job description

Description

Job Title: Medical Billing & Collections Representative - Charlotte, NC location. Not a remote position.

FLSA Status: Non-exempt

Job Summary: We are seeking a detail-oriented and experienced Medical Billing & Collections Representative to join our healthcare team. In this role, you will be responsible for processing and managing medical claims, managing patient accounts, resolving outstanding balances, and ensuring timely payments from insurance providers and patients. The ideal candidate will have strong organizational skills, attention to detail, medical collections, excellent communication skills, and the ability to navigate complex insurance processes to recover payments efficiently.

Essential Duties and Responsibilities:

• Medical Billing: Accurately process medical claims for insurance companies, ensuring the correct codes and information are used for billing and reimbursement.
• Account Management: Review and manage patient accounts with outstanding balances, including follow-up on past due invoices.
• Claim Follow-up: Investigate and resolve billing discrepancies by working with patients, insurance providers, and internal teams.
• Collections Follow-up: Follow up on denied, partially paid, or unpaid claims and ensure timely resolutions to prevent delays in reimbursement.
• Patient Inquiries: Respond to patient inquiries regarding their bills, insurance coverage, and payment options.
• Insurance Verification: Contact insurance companies to verify payment status, resolve claims discrepancies, and secure proper reimbursement for services rendered.
• Documentation: Maintain accurate records of collection activities, including payment plans, disputes, and communications, ensuring that all information is up-to-date and compliant with regulations.
• Compliance: Adhere to federal, state, and company policies, as well as healthcare regulations such as HIPAA, to protect sensitive patient and financial data.
• Financial Reporting: Prepare and submit reports on collection efforts, outstanding accounts, and payment status to management on a regular basis.
• Collaboration: Work closely with billing departments, insurance companies, and other healthcare professionals to resolve complex payment issues.
• Additional duties as assigned.

Requirements

Qualifications:

To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

Education & Experience:

High school diploma or equivalent; Associate degree or certification in medical billing and coding preferred.

Proven experience in medical collections, billing, or a similar role within a healthcare setting.

Strong knowledge of medical billing codes (ICD, CPT, HCPCS), medical insurance policies, and collection procedures.

Familiarity with medical billing software, electronic health records (EHR), and collections systems.

Strong organizational skills with the ability to manage multiple accounts simultaneously. Detail-oriented with a problem-solving mindset

Strong communication and customer service skills, with the ability to handle patient and insurance inquiries professionally.

Knowledge of healthcare regulations and compliance standards, including HIPAA.

Ability to work independently and in a team environment.

Specialized Knowledge Required – Including any required certificates, licenses, and registrations.

Certification in Medical Billing and Coding (e.g., CPC, CCS, or similar).

Experience with a variety of insurance companies and billing systems.

Ability to analyze and resolve complex billing issues.

Experience with a wide variety of insurance companies and knowledge of claim denial processes.

Knowledge of healthcare regulations, including HIPAA, and collections laws.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Light lifting (20-25 pounds), office environment

Must be able to sit for long periods of time.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Office: Standard office equipment; work usually performed in an office setting free from any disagreeable elements. (Not remote)

Travel: As required for position.