Insurance Medical Billing Specialist

Job Description This is a remote position. Job Description We are seeking an Insurance Medical Billing Specialist to manage the end-to-end medical billing process for healthcare services. This role is responsible for accurate claim submission, timely reimbursements, and maintaining compliance with insurance and healthcare regulations. The ideal candidate has strong experience in medical billing, claims management, and denial resolution. This role requires close coordination with providers, insurance companies, and internal teams to support efficient revenue cycle operations and reduce billing issues. • Prepare, review, and submit accurate medical claims to insurance providers • Ensure proper coding using CPT, ICD-10, and HCPCS before claim submission • Monitor claim status and follow up on unpaid, delayed, or rejected claims • Handle claim corrections, resubmissions, and appeals as needed • Verify patient insurance coverage, benefits, eligibility, co-pays, and deductibles • Communicate insurance details clearly to internal teams or patients when necessary • Track outstanding claims and maintain timely reimbursement follow-ups • Follow up on denied or underpaid claims and provide supporting documentation • Maintain accurate records of payment postings, adjustments, and billing activity • Identify denial trends and recommend corrective actions to improve billing accuracy • Investigate and resolve billing discrepancies and coding-related issues • Ensure all billing practices comply with HIPAA and healthcare regulations • Maintain organized and accurate billing documentation • Stay updated on insurance policies, coding standards, and billing procedures • Generate billing reports and track performance metrics such as claim acceptance rate and AR aging • Collaborate with internal teams to improve billing workflows and collection efficiency • Communicate effectively with insurance representatives and stakeholders Requirements • Proven experience in medical billing, insurance billing, or revenue cycle management • Strong knowledge of CPT, ICD-10, and HCPCS coding systems • Experience working with U.S. healthcare insurance providers, including Medicare, Medicaid, and private insurers • Familiarity with EHR, EMR, and medical billing software • Strong understanding of claims processing, denial management, and accounts receivable follow-ups • High attention to detail and accuracy in handling financial data • Strong communication and problem-solving skills • Ability to work independently and manage multiple billing tasks efficiently • Experience in a healthcare, clinic, or medical practice setting is preferred • Certification such as CPC or equivalent is preferred • Experience with Kareo, AdvancedMD, Athenahealth, or similar platforms is preferred • Knowledge of U.S. healthcare compliance and reimbursement processes is preferred