Medical Billing Specialist

DayBreak; Dayton (OH); Sur place; USD 42 000 - 62 000; Plein temps

Résumé du poste

DayBreak in Dayton, OH is seeking a Medical Billing Specialist to ensure accurate claims processing, timely payments, and compliant revenue cycle operations. You will verify insurance, submit claims, monitor status, post payments, and coordinate prior authorizations with payers and internal teams.

The ideal candidate has at least five years in medical billing, familiarity with EHRs and billing software, and strong attention to detail to manage multiple deadlines and audits.

Qualifications

• Five years or more of medical billing/claims processing experience.
• Familiar with payer authorization requirements and billing practices.
• Experience with electronic health records (EHR) and billing software.
• Strong attention to detail and ability to manage multiple claims and authorization deadlines.

Responsabilités

• Review and submit accurate medical claims within required timelines.
• Verify client information, insurance coverage, and billing details.
• Monitor claim status and follow up on unpaid/denied claims; post payments/adjustments.
• Obtain and track prior authorizations for services, and communicate approvals/denials.
• Support account reconciliation and billing reports; identify process improvements.
• Respond to client billing questions professionally and protect confidentiality.
• Stay current with payer requirements and billing guidelines; support compliance.

Connaissances

Attention to detail

Multitasking

Communication

Outils

Billing software

Electronic Health Records (EHR)

Description du poste

Position SummaryThe Medical Billing Specialist is responsible for accurate medical claims processing, payment follow-up, prior authorization coordination, and billing compliance. This role supports timely reimbursement, resolution of billing discrepancies, and continuity of services through effective revenue cycle management and communication with payers and internal teams.Essential Duties and ResponsibilitiesMedical Billing & Claims ProcessingReview and submit accurate medical claims within required timelines.Verify client information, insurance coverage, and billing details.Monitor claim status and follow up on unpaid, denied, or rejected claims.Investigate billing discrepancies and resolve issues with payers and internal teams.Post payments, adjustments, and denials in the billing system.Authorizations & Insurance CoordinationObtain and track required prior authorizations for services, treatments, or procedures.Verify authorization requirements, submit supporting documentation, and follow up with payers on pending requests.Communicate authorization approvals, denials, and expiration dates to relevant staff and clients, as appropriate.Payment Reconciliation & ReportingSupport account reconciliation and maintain accurate billing and payment records.Assist with billing reports and identify opportunities to improve billing processes and revenue cycle operations.Client Communication & ConfidentialityRespond to client billing questions professionally and promptly.Maintain accurate records and protect confidential client information in accordance with applicable privacy requirements.Compliance & Process ImprovementStay current with payer requirements, medical billing guidelines, and applicable regulations.Follow established billing procedures and support continuous improvement in billing accuracy and efficiency.At least five years of experience in medical billing, claims processing, prior authorizations, or revenue cycle operations.Familiarity with payer authorization requirements and medical billing practices.Experience with electronic health records and billing software.Strong attention to detail and ability to manage multiple claims and authorization deadlines.