Medical Billing Specialist

Peyton Resource Group; San Antonio (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

Peyton Resource Group is seeking an experienced Medical Accounts Receivable (AR) Specialist to manage all aspects of medical AR collections for a physician medical group. The role focuses on insurance claim denial follow-up, unpaid claims, and payment recovery.

You will follow up on EOBs, monitor delinquent accounts, resolve patient billing inquiries, and communicate with patients, insurers, and clinic staff to ensure accurate balances and timely payments.

Qualifications

• 2+ years of medical billing and/or collections experience in healthcare.
• Knowledge of CPT, HCPCS, and ICD-10 coding.
• Understanding of HIPAA and patient privacy.
• Familiarity with government programs such as Medicare and Medicaid, TRICARE.

Responsibilities

• Manage assigned medical accounts receivable and insurance payer follow-up to ensure timely payment of outstanding claims.
• Perform claim denial follow-up, research unpaid and underpaid claims, identify billing issues, and pursue options to obtain payment.
• Follow up on zero-payment EOBs and determine next steps for claim resolution.
• Monitor accounts for delinquent payments and use appropriate collection techniques to maintain current AR.
• Research and resolve patient billing inquiries, insurance issues, and account discrepancies.
• Professionally communicate with patients, insurance companies, and clinic staff regarding balances, claims, payments, and billing concerns.

Skills

Medical billing & collections

CPT/HCPCS/ICD-10 coding

HIPAA compliance

Customer communication

Education

High School Diploma or GED

Job description

Our client is seeking an experienced Medical Accounts Receivable (AR) Specialist to manage all aspects of medical AR collections for a physician medical group. This role will focus heavily on insurance claim denial follow-up, unpaid claims, payment recovery, billing issue resolution, and account management.

Key Responsibilities

• Manage assigned medical accounts receivable and insurance payer follow-up to ensure timely payment of outstanding claims.
• Perform claim denial follow-up, research unpaid and underpaid claims, identify billing issues, and pursue available options to obtain payment.
• Follow up on zero-payment Explanation of Benefits (EOBs) and determine appropriate next steps for claim resolution.
• Monitor accounts for delinquent payments and use appropriate collection techniques to maintain current AR.
• Research and resolve patient billing inquiries, insurance issues, and account discrepancies.
• Professionally communicate with patients, insurance companies, and clinic staff regarding account balances, claims, payments, and billing concerns.

Required Qualifications

• High School Diploma or GED.
• 2+ years of medical billing and/or collections experience, preferably within a physician practice, medical group, hospital, or other healthcare setting.
• Knowledge of government insurance programs, including Medicare Part B and C, Medicaid and associated Medicare Advantage plans, and TRICARE.
• Knowledge of commercial insurance plans, including PPO, HMO, EPO, and HRA.
• Working knowledge of CPT, HCPCS, and ICD-10 coding.
• Understanding of HIPAA guidelines and the importance of protecting patient information.