Medical Billing Specialist

TRC Talent Solutions; Washington (District of Columbia); Vor Ort; USD 60.000 - 80.000; Vollzeit

Benefits dieser Stelle

Health, dental, vision, life insurance

Paid time off

Sick leave and holidays

Career advancement opportunities

Zusammenfassung

Gobravvo is seeking a Medical Billing Specialist in Washington, DC to optimize financial performance by managing accounts receivable and resolving denials for hospital and physician billing. This role collaborates with healthcare providers and payer networks to support revenue cycle management services.

Ideal candidates will have 1–2 years in healthcare billing, strong attention to detail, and experience with major RCM systems.

Qualifikationen

• 1–2 years of experience in healthcare provider revenue cycle management.
• High school diploma or equivalent required; associate's or bachelor's degree preferred.
• Knowledge of UB-04 and HCFA 1500 billing, CPT and ICD-10 coding.
• Ability to sit for long periods and maintain focus on details.

Aufgaben

• Perform back-end A/R follow-up and resolve aged accounts for hospital and physician billing.
• Research and resolve denied or underpaid claims to achieve timely resolution.
• Communicate professionally with payers and clients; document interactions.
• Identify A/R trends and payer behaviors to inform leadership.
• Review claims for eligibility discrepancies and correct as needed.
• Submit corrections or rebills and escalate payer errors when necessary.
• Maintain productivity and quality standards across multiple systems.

Kenntnisse

Detail-oriented

Excellent communication

Multitasking

Professionalism

Collaborative attitude

Ausbildung

High school diploma

Associate/Bachelor preferred

Tools

Epic

Cerner

Invision

Soarian

McKesson

Allscripts

Meditech

Jobbeschreibung

The Medical Billing Specialist plays a vital role in optimizing the financial performance of healthcare organizations by ensuring the accurate and timely management of accounts receivable (A/R) and the resolution of denied or underpaid insurance claims. Medical Billing Specialists are responsible for conducting detailed A/R follow-up, resolving aged accounts, and managing claim denials for both hospital and physician billing settings. This key role involves collaborating closely with healthcare providers and hospital entities to remediate third-party accounts receivable and support a variety of revenue cycle management (RCM) outsourcing services.

As a Medical Billing Specialist, you will be tasked with evaluating and pursuing outstanding insurance balances, conducting in-depth research, and problem-solving to bring claims to resolution. Your expertise will help ensure that all assigned accounts are processed efficiently while maintaining compliance with organizational, client, and regulatory standards. Success in this position requires a strong understanding of the healthcare revenue cycle, exceptional communication skills, and the ability to navigate complex billing scenarios with commercial and government payers.

Working as a Medical Billing Specialist offers the opportunity to build a rewarding career in the healthcare industry, with exposure to a variety of billing systems such as Epic, Cerner, Invision, Soarian, McKesson, Allscripts, and Meditech. This role is ideal for candidates looking to develop their skills in revenue cycle management and contribute to the financial health of healthcare organizations.

The environment for Medical Billing Specialists is fast-paced and requires proficiency in multitasking across multiple systems and applications. A strong aptitude for technology, including the Microsoft Suite and major internet browsers, is essential. Attention to detail and the ability to identify billing or coding discrepancies are critical for achieving departmental productivity and quality standards.

Professional growth opportunities are available for Medical Billing Specialists who demonstrate high-quality performance, adherence to productivity metrics, and a proactive approach to identifying and communicating trends or barriers to resolution. If you are passionate about contributing to the success of healthcare organizations and have a background in provider revenue cycle processes, this position could be the next step in your career.

Medical Billing Specialist - Summary

• Responsible for managing back-end A/R follow-up and resolving aged accounts for hospital and physician billing.
• Conducts detailed research and problem-solving on denied, underpaid, or unresolved claims.
• Collaborates with healthcare providers to optimize accounts receivable and revenue cycle performance.
• Ensures compliance with organizational, client, and regulatory guidelines.
• Utilizes a variety of revenue cycle management systems and maintains productivity and quality standards.

Duties & Responsibilities

• Perform account follow-up activities on high-dollar insurance receivables.
• Research and resolve issues requiring further assistance to achieve claims resolution.
• Communicate professionally with colleagues, payers, and clients as needed.
• Apply knowledge of healthcare revenue cycle processes to achieve quality control standards.
• Review and process claims including eligibility discrepancies, UB-04 and/or 1500 claims forms, DRG, per diem, case rate, and fee schedule reimbursements.
• Identify and communicate A/R trends, payer behaviors, and workflow inconsistencies to leadership.
• Document correspondence and assess accounts for balance accuracy, payer billing, coding accuracy, denials, and outstanding insurance requests.
• Submit corrections or elevate payer errors for reprocessing as necessary.
• Identify and request re-bills, secondary billing, or corrected bills as needed.
• Contact third-party payers and government agencies to resolve outstanding balances.
• Maintain departmental productivity and quality standards.
• Utilize general PC skills and type at a minimum of 40 words per minute.
• Competently multitask across multiple applications and systems, including proficiency in Microsoft Suite and internet browsers.

Salary & Benefits

• Permanent positions available with flexible scheduling.
• Comprehensive health, dental, vision, and life insurance packages.
• Paid time off, sick leave, and holidays.
• Opportunities for career advancement within the company.

Qualifications & Requirements

• Minimum 1-2 years of experience in healthcare provider revenue cycle management.
• High school diploma or equivalent required; associate's or bachelor's degree preferred.
• Hands-on experience with Epic, Cerner, Invision, Soarian, McKesson, Allscripts, Meditech, and other RCM systems.
• Knowledge of UB-04 and/or HCFA 1500 billing, CPT and ICD-10 coding, and hospital or ambulatory/physician billing.
• Ability to sit for long periods and perform tasks requiring fine motor skills.

Ideal Candidate Snapshot

• Detail-oriented with strong analytical and problem-solving skills.
• Excellent verbal and written communication abilities.
• Proficient in multitasking and working in fast-paced environments.
• Demonstrates professionalism and a collaborative attitude.
• Committed to quality and accuracy in all work performed.

Other Relevant Information

• Physical requirements include frequent use of hands and fingers, and the ability to exert up to 15 pounds of force occasionally.
• Must be comfortable sitting for extended periods while performing job duties.
• This role supports the financial integrity of healthcare organizations by ensuring timely and accurate resolution of accounts receivable.