Senior Medical Billing and Claims Specialist

Ashbaugh Beal; Albuquerque (NM); On-site; USD 42,000 - 62,000; Full time

Job summary

Ashbaugh Beal is seeking a Central Billing Representative II to manage patient accounts receivable and third-party claims. You will reconcile, research, correct, and resubmit claims while communicating with payers to resolve issues and ensure payment.

You will handle patient inquiries, review EOBs, coordinate statements, and stay current with Medicare/Medicaid regulations. This role requires strong attention to detail and billing knowledge in a multispecialty clinic setting.

Qualifications

• High school diploma or GED required.
• Two years in healthcare billing/claims experience.
• Experience in a multispecialty clinic setting preferred.
• Certified Coder or Billing Certificate preferred.
• Knowledge of CPT, ICD-10 and UB04/HCFA1500 forms.

Responsibilities

• Reconcile, review, research, coordinate and justify changes to claim forms and submit to third party payers.
• Follow up on claims denials and resubmit for payment; appeal denials as required.
• Research unpaid claims and contact patients to obtain information for payments.
• Handle patient inquiries, complaints and customer service issues.
• Coordinate electronic patient statements monthly and review credit balances for refunds.
• Review EOBs and initiate clean claim resubmissions; ensure proper coding.
• Educate and assist with billing questions; maintain knowledge of Medicare/Medicaid rules.

Skills

Attention to detail

Communication skills

Multi-tasking

Problem solving

Education

High school diploma or GED

Certified Coder (medical and/or dental)

Billing Certificate

Tools

Cerner EHR

MS Windows

Job description

Ashbaugh Beal is seeking a Central Billing Representative II to manage patient accounts receivable and third-party claims. You will reconcile, research, correct, and resubmit claims while communicating with payers to resolve issues and ensure payment.

You will handle patient inquiries, review EOBs, coordinate statements, and stay current with Medicare/Medicaid regulations. This role requires strong attention to detail and billing knowledge in a multispecialty clinic setting.