Medical Billing Specialist - Claims, Denials & Appeals

Carenomics; Lubbock (TX); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Dental insurance

Vision insurance

401(k)

Employee discounts

Health insurance

Paid time off

Competitive Compensation

Great Work Environment

Career Advancement Opportunities

Job summary

Carenomics is seeking a Medical Biller to ensure timely and accurate submission and follow-up of medical claims, with strong collaboration with clinical and administrative staff. Knowledge of insurance verification and billing is essential.

The ideal candidate will have wound-care billing experience, be comfortable working independently, and maintain patient confidentiality under HIPAA regulations.

Qualifications

• Candidates should have strong customer service and communication skills.
• Experience with medical coding or billing is preferred.
• Excellent organizational abilities and attention to detail.
• Ability to work independently and maintain confidentiality.

Responsibilities

• Prepare, review, and submit clean medical claims to insurance companies.
• Review claims for accuracy and completeness prior to submission.
• Follow up on unpaid, rejected, and denied claims.
• Research and resolve claim denials and billing issues.
• File and track insurance appeals and reconsiderations.
• Work accounts receivable and identify outstanding balances requiring follow-up.
• Verify insurance eligibility and benefits when needed.
• Review patient accounts for accurate charges, payments, adjustments, and balances.
• Post insurance and patient payments accurately.
• Monitor aging reports and prioritize accounts based on timely filing and other payer deadlines.
• Communicate with insurance companies regarding claim status, payment issues, denials, and appeals.
• Maintain accurate documentation of billing follow-up and correspondence.
• Identify recurring billing issues and communicate them to management.
• Work closely with clinical and front-office staff to resolve missing or incorrect information.
• Maintain patient confidentiality and comply with HIPAA regulations.
• Assist with Medicare, Medicaid, Medicare Advantage, commercial insurance, and other payer requirements.
• Stay current with payer requirements, billing guidelines, and changes affecting wound-care services.
• Perform other billing and administrative duties as assigned.

Skills

Strong customer service

Medical billing experience

Organization skills

Attention to detail

Job description

Carenomics is seeking a Medical Biller to ensure timely and accurate submission and follow-up of medical claims, with strong collaboration with clinical and administrative staff. Knowledge of insurance verification and billing is essential.

The ideal candidate will have wound-care billing experience, be comfortable working independently, and maintain patient confidentiality under HIPAA regulations.